Immature platelet fraction in predicting sepsis in critically ill patients

Abstract

In patients without sepsis at ICU admission IPF% increases before sepsis becomes manifest. Measuring IPF% through an easily available technology can therefore provide an early cellular marker predicting the development of sepsis.

Immature platelet fraction predicts coagulopathy-related platelet consumption and mortality in patients with sepsis

“…Several studies have demonstrated the clinical utility of IPF in laboratory diagnosis of thrombocytopenia due to peripheral platelet destruction, particularly autoimmune thrombocytopenic purpura and thrombotic thrombocytopenic purpura [12,13]. The IPF was recently introduced as a novel diagnostic biomarker for infection and developing sepsis [14,15]. To our knowledge, however, no studies have evaluated the clinical value of IPF for coagulopathy or its prognostic value in patients with sepsis.…”

“…Blasi et al [14] reported that IPF was increased before sepsis became clinically overt and was a predictor of sepsis when procalcitonin, C-reactive protein, and the white blood cell count were not. In other studies, an increased IPF was related to suspected bacterial infection and the severity of sepsis [15,27].…”

“…Platelets are divided into two groups-mature and immature-according to the intensity of cell fluorescence, which correlates with the RNA content and is consequently higher in immature platelets. The IPF corresponds to the fraction (%) of immature platelets in the total platelet population [14,15]. The AIPC was calculated as the absolute number of immature platelets per unit volume (%IPF × platelet count).…”

Clinical applicability of reticulated platelets

“…It has recently been demonstrated that critically ill ICU patients have increased circulating RPs prior to the onset of sepsis [59].…”

Year in review in Intensive Care Medicine 2013: II. Sedation, invasive and noninvasive ventilation, airways, ARDS, ECMO, family satisfaction, end-of-life care, organ donation, informed consent, safety, hematological issues in critically ill patients

“…They demonstrated that bone marrow aspiration yielded novel diagnoses in 22 % of patients, resulting in significant impact on management in 11 % of patients, particularly in those with absolute thrombocytopenia. De Blasi et al [81] investigated whether changes in the percentage of immature platelet fraction (IPF %) could be useful in predicting the development of sepsis over the first week of ICU stay in critically ill patients without sepsis at ICU admission. They demonstrated that significant increases in IPF values preceded the subsequent development of sepsis by a median of 2 days.…”