title: Response of platelet concentrates to pressure and temperature changes without impairment of the in vitro function.
abstract: BACKGROUND
  Rapid platelet concentrate (PC) transfusion is crucial for hemostatic resuscitation. Pressure-aided and warmed transfusion combined with pneumatic tube system (PTS) transport from the laboratory to the operating theatre offers a potentially rapid delivery technique. The aim of this study is a quantitative assessment of in vitro platelet function after PTS transport followed by warmed and/or pressure-aided mock transfusions.
  
  
  METHODS
  Ten PC samples entered a single PTS run and were subsequently aliquoted for testing. PCs were warmed in a blood warmer and/or subjected to pressure-aided mock transfusion at 300 mm Hg on day 2 or day 7 after collection. Platelet function was assessed using light-transmission aggregometry and multiple-electrode aggregometry to measure the response to ADP, arachidonic acid, collagen, and thrombin-receptor activating peptide. Data were analyzed with non-parametric testing; P<0.05 was considered statistically significant.
  
  
  RESULTS
  Single PTS transport markedly reduced ADP response in fresh PCs. Seven-day storage had a pronounced effect on both ADP and collagen response. All other tested platelet agonists revealed preserved function. Subsequent warming and/or application of pressure did not significantly compromise platelet function.
  
  
  CONCLUSIONS
  Pressure-aided plus warmed transfusion and PTS transport was not found to be detrimental to the PC. Further clinical studies are required to determine safety and efficacy of the product.
authors.affiliation: Dept. of Anesthesiology, Maastricht University, The Netherlands.
authors.forename: Cécile
authors.initials: C
authors.lastname: Kicken
authors.affiliation: Dept. of Anesthesiology, Intensive Care Medicine, Emergency Care Pain Therapy ZOL Genk, Belgium. Electronic address: svanpoucke@gmail.com.
authors.forename: Sven
authors.initials: S
authors.lastname: Van Poucke
authors.affiliation: Dept. of Anesthesiology, Maastricht University, The Netherlands; Dept. of Anesthesiology, ICU and Perioperative Medicine, HMC, Doha, Qatar.
authors.forename: Abraham Emanuel
authors.initials: AE
authors.lastname: Marcus
authors.affiliation: Dept. of Anesthesiology, Maastricht University, The Netherlands.
authors.forename: Marcus D
authors.initials: MD
authors.lastname: Lancé
authors.affiliation: Hematological Laboratory, Maastricht University Medical Centre, Maastricht, the Netherlands.
authors.forename: Yvonne
authors.initials: Y
authors.lastname: Henskens
mesh_terms: D001792:Blood Platelets / Q000502:physiology*; D006801:Humans; D066298:In Vitro Techniques / Q000379:methods*; D008875:Middle Aged; D010979:Platelet Function Tests / Q000379:methods*; D013696:Temperature
keywords: Aggregometry; Platelets; Pneumatic tube system; Transfusion