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Mean platelet volume trend in sepsis: is it a useful parameter?
C Becchi1, M Al Malyan, L P Fabbri
1Department of Medical and Surgical Critical Care, Section of Anaesthesia and Intensive Care, University of Florence, Florence, Italy. chiarabecchi@hotmail.com
Aim:
Sepsis, as an uncontrolled generalized inflammatory response, involves also the haemostatic mechanisms. Mean platelet volume (MPV) measurement has been available since 1970s, but neither its relationship with platelet count nor the clinical meaning of this relation has been understood in sepsis yet. This study aimed to evaluate both the trend and the relationship between platelet count (PC) and their MPV and to explore their significance in the course of sepsis.
Methods:
Seventy septic patients, were recruited in this prospective study. The PC and MPV were measured repeatedly at the enrollment and, thereafter, whenever patient's sequential organ failure assessment (SOFA) score changed by +/-8% up to 5 samples. Standard correlation test, ANOVA for repeated measures, logistic regression and Wilcoxon test were used.
Results:
The relationship between PC and MPV, expressed as means and frequency distributions, showed a negative correlation (95% CI; r -0.34; P<0.0001) with an inverse trend during sepsis course. The logistic regression showed a three times increase in death probability (95% CI; OR=3.04; P<0.05) of patients with a MPV<9.7 fL at the recruitment time.
Conclusions:
The behaviour of platelets and their respective MPV could be an indirect sign of disturbance in platelet production and activity, and bone marrow response in sepsis. Our results could suggest that routine concomitant measurement of PC and MPV trend could be considered as a quick and reliable guide in the assessment of bone marrow response to sepsis evolution.
Insights
In sepsis patients, a lower mean platelet volume (MPV) indicates a higher risk of death. Monitoring MPV alongside platelet count can assess bone marrow response during sepsis.
Area of Science:
- Hematology
- Critical Care Medicine
- Pathophysiology
Background:
- Sepsis involves uncontrolled inflammation affecting hemostatic mechanisms.
- The relationship between platelet count (PC) and mean platelet volume (MPV) in sepsis remains unclear.
- MPV measurement is a long-standing but underutilized tool in sepsis research.
Purpose of the Study:
- To evaluate the trend and relationship between PC and MPV in sepsis patients.
- To explore the clinical significance of PC and MPV in the course of sepsis.
- To determine if MPV can predict outcomes in sepsis.
Main Methods:
- Prospective study of 70 septic patients.
- Repeated measurements of PC and MPV based on SOFA score changes.
- Statistical analyses included correlation tests, ANOVA, logistic regression, and Wilcoxon test.
Main Results:
- A significant negative correlation (r=-0.34, P<0.0001) was observed between PC and MPV.
- An inverse trend in MPV was noted during sepsis progression.
- MPV < 9.7 fL at recruitment was associated with a threefold increase in death probability (OR=3.04, P<0.05).
Conclusions:
- Platelet behavior (PC and MPV) may reflect bone marrow response and platelet production/activity disturbances in sepsis.
- Concomitant monitoring of PC and MPV trends can serve as a reliable indicator of bone marrow response to sepsis.
- Routine MPV measurement could enhance sepsis assessment and patient management.