Platelet aggregation and blood rheology in severe sepsis/septic shock: relation to the Sepsis-related Organ Failure Assessment (SOFA) score.
Abnormalities in blood rheology and platelet dysfunction might play a role in the pathogenesis of multiple organ failure in septic patients by reducing microvascular blood flow. To determine whether alterations in blood rheology and in platelet function are related to the severity of organ dysfunction, we prospectively studied plasma fibrinogen, red cell aggregation, plasma viscosity, hematocrit, whole blood viscosity and platelet aggregation in relation to the Sepsis-related Organ Failure Assessment (SOFA) score in 34 consecutive patients with severe sepsis/septic shock. We found that patients had higher plasma fibrinogen, red cell aggregation and plasma viscosity (p < 0.01), but lower hematocrit, whole blood viscosity and ADP-induced platelet aggregation than controls (p < 0.01). Platelet aggregation (p < 0.01), but not other rheological variables, were inversely related to the SOFA score. Only platelet count was linked to poor clinical outcome (p < 0.05). We conclude that blood rheology and platelet function are severely altered in patients with severe sepsis/septic shock. Our findings suggest progressive platelet dysfunction with advancing severity of the disease. Platelet dysfunction might play a more important role in the pathogenesis of the multi organ dysfunction syndrome than abnormalities in blood rheology.
Alt
Elisabeth
E
Division of Angiology, Department of Medicine, University Hospital Zurich, Switzerland.
Amann-Vesti
Beatrice R
BR
Madl
Christian
C
Funk
Georg
G
Koppensteiner
Renate
R
D018806:APACHE; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001772:Blood Cell Count; D005260:Female; D005340:Fibrinogen / Q000032:analysis; D018056:Hemorheology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010974:Platelet Aggregation; D012720:Severity of Illness Index; D012772:Shock, Septic / Q000097:blood*; D018746:Systemic Inflammatory Response Syndrome / Q000097:blood*; D016896:Treatment Outcome
D005340:Fibrinogen