I am interested in investigating platelet activity and would be grateful If anyone can recommend quick and easy bedside tests for platelet activity or absolute count. Are there are any surrogates of such parameters? Many thanks in advance.
Platelet function is overall difficult to determine as a simple and reliable bedside test. However, some companies provide small machines that allow to assess platelet function at point-of-care, including the "VerifyNow". Paul Harrison has published a good summary: Hämostaseologie 2009; 29: 25–31
Platelet function includes adhesion, activation and aggregation. Hense multiple methords could be used, like static adhesion, flow chanber and platelet aggregation test. I would like to prefer flow cytometry to test the platelet activation via integrin alphaIIbbetaIII activation and p-selectin expression.
There are human monoclonal antibodies that measure platelet activity by targeting integrins IaIIa and IIbIIIa.
Among these human monoclonal antibodies clone B4F12, which is specific for the integrin IIbIIIa, binds to the blood platelet by FACS as soon as it is activated.
B4F12 may also inhibit blood platelet aggregation only if activated.
Another human clone, F2H11, can bind to platelets via integrin IIbIIIa, and specifically inhibiting aggregation HPA5b + isoforms in the same conditions as ReoPro, but the latter is ubiquitous and binds to integrin IaIIa.
B4F12 and F2H11 are functional in ELISA and MAIPA.
I believe VerifyNow is the only "bedside" test available. However, this only tests ADP aggregation so is limited in interpretation.
I think that platelet function avaliation is very complex to have or to use a "bedside" test . I would like to prefer flow cytometry and its not possible do like a "bedside" test.
THe Multiplate is also a bedside platelet aggregation measuring device which is very versatile with many activators available. Four channels to do 4 different aggregation tests. The tests takes about 10 minutes whole blood measurement. Many papers are published on this device. I found this device useful in cardiac surgery. I have none connections with the company.
As a nephrologist (nb. uremic bleeding diathesis largely results from defective platelat-vessel wall interactions) I would recommend the clinically simple and quite reliable skin bleeding time according to Ivy. Forgotten but very useful.. Allways think about actual hematocrit as anemia exacerbates primary coagulation .
The mean platelet volume gives a rapid screening measure of platelet function as large platelets denote hyperfunction by virtue of increased platelet contents, while smaller volume platelets are less functioning.
Others have said it, appart from the VerifyNow and the Multiplate there are few devices that can give an insight into platelets and are simple. There's also the PFA100 but it's not a bedside device.
The Chrono-log WBA (Whole Blood Aggregometer) can also be used as a bedside test for platelet activity/platelet function. It is a rapid, reliable, and cost effective instrument offering not only the capability to perform routine platelet screening but also monitor/screen anti-platelet drugs and detect specific platelet abnormalities. The procedure is simple...add the whole blood sample to the test well and then add your reagent of choice. For example, when running an Aspirin screen, to determine whether a patient is responding to treatment, Collagen is added to two whole blood samples in high/low concentrations. This particular screen can be performed within in 15 minutes and it is reimbursable, when performed in a clinical lab setting.
I agree with Rolf Huet. We use the Multiplate analyzer to assess platelet function in a point-of-care setting. Mostly it is used in cardiac anesthesia. However, there are quite good data on the use published by Görlinger K et al. and Weber CF et. al.
Dear Ussamah El-khani,
I recently published a new article describing a novel method to measure platelet function using automated microscopy. The positive aspects of this new method are: 1) it requires only 10 000 platelets per well and 2) it is a label-free microscope technique. Therefore, it is feasible for drug screening and for measuring platelet function from mice (which the blood volume is a limiting factor for aggregometry). In addition, we also validate the assay for a high-throughput screening format using absorbance and luminescence.
Article An optimized and validated 384-well plate assay to test plat...
Cheers,
Augusto
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