Observational studyJournal of thrombosis and haemostasis : JTH2015
Viscoelastic measurements of platelet function, not fibrinogen function, predicts sensitivity to tissue-type plasminogen activator in trauma patients.
Observational study in Journal of thrombosis and haemostasis : JTH, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 49 papers.
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Who cites it
49 citing papers in PubMed, 97 citations in OpenAlex.
- Fibrinolysis Resistance After Injury Is a Risk Factor for a Hospital-Acquired Pneumonia-Like Disease Pattern.Surgical infections · 2024Trial
- TEG Lysis Shutdown Represents Coagulopathy in Bleeding Trauma Patients: Analysis of the PROPPR Cohort.Shock (Augusta, Ga.) · 2019Trial
- Whole blood becomes increasingly susceptible to tPA-mediated fibrinolysis with storage.The journal of trauma and acute care surgery · 2026Article
- Platelet recruitment kinetics are impacted by von Willebrand factor quality in hemostatic adjuncts.Blood vessels, thrombosis & hemostasis · 2025Article
- Phase I clinical trial of the feasibility and safety of direct peritoneal resuscitation in liver transplantation.American journal of surgery · 2024Article
- Blood failure: traumatic hemorrhage and the interconnections between oxygen debt, endotheliopathy, and coagulopathy.Clinical and experimental emergency medicine · 2024Article
- Thromboelastogram and coagulation function index: relevance for female breast cancer.Frontiers in oncology · 2024Article
- Shear Stress and Endothelial Mechanotransduction in Trauma Patients with Hemorrhagic Shock: Hidden Coagulopathy Pathways and Novel Therapeutic Strategies.International journal of molecular sciences · 2023Review
- Fibrinolysis Shutdown and Hypofibrinolysis Are Not Synonymous Terms: The Clinical Significance of Differentiating Low Fibrinolytic States.Seminars in thrombosis and hemostasis · 2023Review
- Review
- Point-of-care diagnosis and monitoring of fibrinolysis resistance in the critically ill: results from a feasibility study.Critical care (London, England) · 2023Article
- Fibrinolysis resistance after liver transplant as a predictor of early infection.American journal of surgery · 2022Article
- Apolipoprotein A-I, elevated in trauma patients, inhibits platelet activation and decreases clot strength.Platelets · 2022Article
- Omics Markers of Red Blood Cell Transfusion in Trauma.International journal of molecular sciences · 2022Article
- Retention of functional mitochondria in mature red blood cells from patients with sickle cell disease.British journal of haematology · 2022Article
- COVID-19 patient plasma demonstrates resistance to tPA-induced fibrinolysis as measured by thromboelastography.Journal of thrombosis and thrombolysis · 2021Article
- Plasma proteomic profile associated with platelet dysfunction after trauma.Journal of thrombosis and haemostasis : JTH · 2021Observational
- Trauma-induced coagulopathy.Nature reviews. Disease primers · 2021Review
- Review
- Glycocalyx components affect platelet function, whole blood coagulation, and fibrinolysis: an in vitro study suggesting a link to trauma-induced coagulopathy.BMC anesthesiology · 2021Article
Corrections and comments
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Authors and funding
11 authors at 4 institutions in 1 country.
Funding
Abstract
backgroundSystemic hyperfibrinolysis is a lethal phenotype of trauma-induced coagulopathy. Its pathogenesis is poorly understood. Recent studies have support a central role of platelets in hemostasis and in fibrinolysis regulation, implying that platelet impairment is integral to the development of postinjury systemic hyperfibrinolysis.
objectiveThe objective of this study was to identify if platelet function is associated with blood clot sensitivity to fibrinolysis. We hypothesize that platelet impairment of the ADP pathway correlates with fibrinolysis sensitivity in trauma patients.
methodsA prospective observational study of patients meeting the criteria for the highest level of activation at an urban trauma center was performed. Viscoelastic parameters associated with platelet function (maximum amplitude [MA]) were measured with native thrombelastography (TEG), and TEG platelet mapping of the ADP pathway (ADP-MA). The contribution of fibrinogen to clotting was measured with TEG (angle) and the TEG functional fibrinogen (FF) assay (FF-MA). Another TEG assay containing tissue-type plasminogen activator (t-PA) (75 ng mL(-1) ) was used to assess clot sensitivity to an exogenous fibrinolytic stimulus by use of the TEG lysis at 30 min (LY30) variable. Multivariate linear regression was used to identify which TEG variable correlated with t-PA-LY30 (quantification of fibrinolysis sensitivity).
resultsFifty-eight trauma patients were included in the analysis, with a median injury severity score of 17 and a base deficit of 6 mEq L(-1) . TEG parameters that significantly predicted t-PA-LY30 were related to platelet function (ADP-MA, P = 0.001; MA, P < 0.001) but not to fibrinogen (FF-MA, P = 0.773; angle, P = 0.083). Clinical predictors of platelet ADP impairment included calcium level (P = 0.001), base deficit (P = 0.001), and injury severity (P = 0.001). RESULTS AND
conclusionsPlatelet impairment of the ADP pathway is associated with increased sensitivity to t-PA. ADP pathway inhibition in platelets may be an early step in the pathogenesis of systemic hyperfibrinolysis.
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