![]() ![]() We therefore investigated the changes in PDW and MPV over time in CA patients treated with targeted temperature management (TTM) and their relationship with outcome. It would be interesting to better characterize the prognostic role of these two biomarkers, as they could be used in the future to identify patients with platelet hyperfunction or increased platelet aggregation after CA, who may require for more aggressive antiplatelet therapy, or those with the highest risk of organ dysfunction or systemic reperfusion injury, who might be treated with specific therapeutic approaches. PDW and MPV have not been widely studied in survivors of CA. These indices, which can be obtained easily from routine blood analysis, have been associated with the occurrence of organ dysfunction during sepsis and an increase in PDW greater than 18% considered as an expression of platelet activation, both being correlated with mortality. In the last few years, there has been increasing interest in platelet variables, such as platelet distribution width (PDW), an indicator of variation in platelet size, and mean platelet volume (MPV), for the diagnosis of various conditions associated with altered platelet counts, including sepsis. The activation of multiple inflammatory pathways results in platelet activation and an imbalance between endogenous coagulation and fibrinolysis pathways however, these abnormalities are not easily characterized in clinical practice. Moreover, the ischemia/reperfusion injury occurring after the return of spontaneous circulation (ROSC) can contribute to a systemic inflammatory response, similar to that observed in septic patients, which may contribute to organ injury. In our cohort of post-CA patients, PDW and MPV were not associated with outcome.ĭespite improvements in the management of patients with cardiac arrest (CA), outcomes remain poor, mainly because of associated cardiogenic shock and post-anoxic brain damage. There were no significant differences between the values on admission or time-courses of platelet count, PDW or MPV between survivors and non-survivors or between patients with unfavorable and favorable neurological outcome. Platelet count decreased significantly over the first 2 days, whereas PDW and MPV did not change significantly. On admission, platelet count, PDW and MPV were 87 *10 3cells/mm 3, 17 % and 8.3 μm 3, respectively. We included 384 patients (age 62 years 270/384 male): 231 patients (60%) died within 30-days and 246 patients (64%) had an unfavorable 3-month neurological outcome. Unfavorable 3-month neurological outcome was defined as a cerebral performance category score of 3–5. We retrieved all data concerning CA characteristics as well as platelet count, PDW and MPV on the first 2 days of admission. MethodsĪll adult CA patients admitted to the intensive care unit (ICU) over an 8-year period (2006–2014) and treated with targeted temperature management were included. We evaluated these variables in patients after cardiac arrest (CA). Platelet variables, including platelet distribution width (PDW) and mean platelet volume (MPV), have been associated with outcome in critically ill patients. ![]()
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