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Updated: Sep 19, 2025
Microfluidics in Assessing Platelet Function
Published on: November 8, 2024
Platelet dysfunction in trauma: a sub study of the FEISTY pilot trial analysing whole blood aggregometry data
Zachary J Durkin1, Stephen F Whebell1, Martin Wullschleger2
1Intensive Care Unit, Townsville University Hospital, 100 Angus Smith Drive, Douglas, Queensland, 4814, Australia.
Objective:
To identify platelet hypofunction and its associations in severely injured trauma patients presenting with haemorrhage.
Design:
Planned sub-study of data collected from the FEISTY trial; an Australian multicentre, randomised controlled pilot trial investigating early fibrinogen replacement in severely injured trauma patients.
Setting:
Four major trauma centres in Queensland, Australia.
Participants:
Adult trauma patients (age ≥18 years) presenting with clinically significant haemorrhage or potential for significant transfusion requirements.
Main Outcome Measures:
Platelet function parameters arachidonic acid (ASPI), adenosine diphosphate (ADP), and thrombin receptor-activating peptide (TRAP) assessed via Multiplate® analysis, rotational thromboelastometry (ROTEM®) parameters EXTEM, FIBTEM, and PLTEM (EXTEM - FIBTEM), transfusion requirements, and clinical outcomes.
Results:
Significant platelet hypofunction was detected in this cohort of severely injured trauma patients at time of presentation, with 70 % of patients having hypofunction in at least one Multiplate® channel. The median ASPI area under the curve and 95 % confidence interval were below the lower reference range, indicating this population had reduced platelet function. In patients with deranged platelet function, significantly lower platelet count (p ≤ 0.001), EXTEM amplitude at five minutes (A5) and maximum clot firmness (MCF) (p = 0.001, p ≤ 0.001), and PLTEM A5 and MCF (p = 0.005, p = 0.003) were identified compared to patients with normal platelet function. A significant improvement in platelet function parameters was not observed following platelet transfusion.
Conclusion:
Platelet hypofunction is common in severely injured trauma patients. This was true both before and after platelet transfusion, suggesting trauma precipitates alteration of the vascular circulating milieu in a way that impairs platelet function. Characterisation of this change might lead to targeted interventions to improve haemostasis.
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