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Early Platelet Transfusion Improves Platelet Activity and May Improve Outcomes After Intracerebral Hemorrhage Full Text
Neurocritical Care , 08/16/2011
Naidech AM et al.– In patients at high risk for hemorrhage growth and poor outcome, early platelet transfusion improved platelet activity assay results and was associated with smaller final hemorrhage size and more independence at 3 months.
Methods- The authors prospectively identified consecutive patients with ICH who had reduced platelet activity on admission and received a platelet transfusion.
- They defined high–risk patients as per a previous publication, reduced platelet activity, or known anti–platelet therapy (APT) and the diagnostic CT within 12 h of symptom onset.
- Platelet activity was measured with the VerifyNow–ASA (Accumetrics, CA), ICH volumes on CT with computerized quantitative techniques, and functional outcomes with the modified Rankin Scale (mRS) at 3 months.
- Forty–five patients received a platelet transfusion with an increase in platelet activity from 472±50 (consistent with an aspirin effect) to 561 ± 92 aspirin reaction units (consistent with no aspirin effect, P<0.001).
- For high–risk patients, platelet transfusion within 12 h of symptom onset, as opposed to >12 h, was associated with smaller follow–up hemorrhage size (8.4 [3–17.4] vs. 13.8 [12.3–62.5] ml, P=0.04) and increased odds of independence (mRS<4) at 3 months (11 of 20 vs. 0 of 7, P=0.01).
- There were similar results for patients with known APT.