Affiliations: Division of Angiology, Department of Medicine, University Hospital Zurich, Switzerland | Medical Intensive Care Unit, Department of Internal Medicine IV, University of Vienna, Austria
Note: [] Corresponding author: Renate Koppensteiner, MD, Division of Angiology, Departement of Medicine, University Hospital Zurich, Raemistrasse 100, CH‐8091 Zurich, Switzerland. Tel.: +41 1 255 26 79; Fax: +41 1 255 45 10; E‐mail: renate.koppensteiner@usz.ch.
Abstract: Abnormalities in blood rheology and platelet dysfunction might play a role in the pathogenesis of multiple organ failure in septic patients by reducing microvascular blood flow. To determine whether alterations in blood rheology and in platelet function are related to the severity of organ dysfunction, we prospectively studied plasma fibrinogen, red cell aggregation, plasma viscosity, hematocrit, whole blood viscosity and platelet aggregation in relation to the Sepsis‐related Organ Failure Assessment (SOFA) score in 34 consecutive patients with severe sepsis/septic shock. We found that patients had higher plasma fibrinogen, red cell aggregation and plasma viscosity (p<0.01), but lower hematocrit, whole blood viscosity and ADP‐induced platelet aggregation than controls (p<0.01). Platelet aggregation (p<0.01), but not other rheological variables, were inversely related to the SOFA score. Only platelet count was linked to poor clinical outcome (p<0.05). We conclude that blood rheology and platelet function are severely altered in patients with severe sepsis/septic shock. Our findings suggest progressive platelet dysfunction with advancing severity of the disease. Platelet dysfunction might play a more important role in the pathogenesis of the multi organ dysfunction syndrome than abnormalities in blood rheology.
