Signature Library: Poor Platelet Function

The poor platelet function examples are presented beginning with extreme platelet dysfunction and progressing to moderate dysfunction, then to mild dysfunction.

    This first example of poor platelet function could be characterized as complete platelet dysfunction. The sample forms a good gel, but no retraction occurs. This sample was a pre-surgery screen for a patient undergoing a liver transplant. Additional Sonoclot Signatures from this case are included in Sonoclot Overview: Liver Transplant Example 1.

    The Signature to the left shows almost no evidence of clot retraction. The slight rise occurring between 6 and 8 minutes on the Signature indicates possible platelet activation, but clot retraction did not occur. This Signature was run post protamine during cardiovascular surgery as seen in Sonoclot Overview: Cardiovascular Surgery Example 2.

    The clinical context of this Signature is discussed in the Sonoclot Overview: Cardiovascular Surgery Example 3. This Signature shows some clot retraction, but the peak is dull and prolonged.

The Signatures below show the response of a 22 kg child to a 6 pack of platelets after cardiovascular surgery. The Signature on the left shows both a poor gel and minimal clot retraction. The Signature on the right shows the same patient after receiving 6 packs of platelets. The post platelet Signature shows dramatic and rapid clot retraction - far greater than normal. Perhaps 6 packs of platelets was overkill.
Pediatric Cardiovascular Bypass Case
 

    
Post Pump
    Before Platelets

The last poor platelet function example is provided below. The Sonoclot Signature has clot retraction (Time to Peak: 26 minutes), but the retraction is prolonged. This example falls into that gray area of marginal platelet function to mild platelet function deficiency.

The platelet function is longer than average but not significantly abnormal. If this patient was oozing in the operating room or experiencing excessive postoperative bleeding, platelets would likely improve hemostatic performance. If the patient does not show signs of bleeding, then hemostasis apparently is adequate despite slow clot retraction.




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