EXPEDIENCE OF PLATELET TRANSFUSION IN TRAUMATIC BRAIN INJURY DOES NOT IMPROVE INHIBITION

Objectives: To improve outcomes in traumatic brain injury (TBI), secondary injury must be prevented. Progression of TBI can result in devastating consequences. In TBI patients, platelet inhibition is known to occur and transfusion of platelets may improve inhibition and decrease bleed progression. We hypothesized that earlier transfusion of platelets after diagnosis of TBI with platelet inhibition would lead to improvement in the percent of inhibition and decrease the rate of bleed progression.

Methods: All adult patients presenting to a level 1 trauma center with TBI received a thromboelastography with platelet mapping (TEG-PM) assay from December 2019 to July 2020. Patients found to exhibit platelet inhibition were transfused a single unit of platelets. Time to transfusion, response measured by TEG, and bleed progression were recorded and reviewed retrospectively.

Results: No correlation between time to receiving platelets (minutes) and response to platelet transfusion in terms of percent adenosine diphosphate inhibition (p=0.632), percent arachidonic acid inhibition (p=0.718), and max amplitude (p=0.133) was noted. The logistic regression model was not statistically significant, χ21= 0.01, p=0.916. Time to receive platelets (p=0.916) was not associated with decreased bleed progression.

Conclusion: Although platelet transfusion has been shown to improve platelet inhibition, as measured by the TEG-PM assay, and bleed progression in TBI, time from diagnosis to platelet administration does not appear to impact these variables.