Platelet function and inflammatory markers in septic patients

Background

In septic patients disseminated intravascular coagulation is a severe complication whereby an altered platelet function appears contributory. Clinical outcome depends on an early diagnosis and sufficient therapy. In the present study the association of platelet function to inflammatory markers indicating disease severity was investigated.

Methods

Inflammatory markers C-reactive protein, procalcitonin, interleukin-6 and interleukin-10 were measured using standard methods in 18 patients fulfilling clinical, inflammatory and hemodynamic criteria of sepsis. Platelet activation marker P-selectin was flow cytometrically analysed ex vivo and after stimulation using 5 μmol/l ADP and 10 μmol/l TRAP-6.

Results

Flow cytometrically measured platelet function was tightly associated with inflammatory markers. Pre-activation of platelets in the circulation was significantly correlated to plasma levels of procalcitonin (P < 0.023), whereas in vitro induced reagibility after ADP- and TRAP-6 stimulation correlated well with the plasma concentration of the C-reactive protein (P < 0.001; P < 0.012). Furthermore, a close relation of IL-6, but not of IL-10, plasma levels to TRAP-6 stimulated P-selectin expression was observed (P < 0.033).

Conclusion

Platelet function was demonstrated to be tightly associated with the inflammation process in septic patients. Whether this finding may be a useful marker for disease severity and the development of a disseminated intravascular coagulation should be clarified in prospective studies.