Effectiveness of complete blood count parameters for predicting intracranial injury in children with minor head trauma

Objective: We aimed to investigate the relationship between trauma severity and platelet indices (PI) and white blood cell (WBC) count to identify traumatic brain injury (TBI) in children with minor head trauma (MHT). Materials and methods: This prospective study included children with acute isolated MHT who underwent head computed tomography (CT) based on Pediatric Emergency Care Research Network (PECARN) criteria. Mean platelet volume (MPV), platelet distribution width (PDW), MPV to platelet ratio (MPV/PL), MPV to white blood cell ratio (MPV/WBC), and MPV to Neutrophil ratio (MPV/Neu) were evaluated. Results: 86 children with MHT and 245 controls were included the study. WBC, Neu count, MPV, MPV/WBC, MPV/Neu and MPV/PI ratios were statistically different among patients with abnormal CT, patients with normal CT and healthy controls (p < 0.05). For predicting abbreviated injury score (AIS) > 1, the AUC values of WBC, neutrophil, MPV/WBC and MPV/Neu were 0.746, 0.739, 0.726 and 0.724, respectively. Conclusion: In children with MHT who underwent CT, WBC, Neu counts, MPV/WBC and MPV/Neu ratios may be helpful for predicting the severity of trauma in pediatric emergency department.

Assessment of platelets morphological changes and serum butyrylcholinesterase activity in children with diabetic ketoacidosis: a case control study

BACKGROUND

Many studies indicated that mean platelet volume (MPV) and platelet distribution width (PDW) may be valuable in the diagnosis and management of clinical disorders; also, serum butyrylcholinesterase activity (BChE) was suggested to be linked to systemic inflammation and oxidative stress. Limited studies measured these readily available markers in children with diabetic ketoacidosis (DKA). Our objectives were to measure MPV, PDW and BChE in children with DKA; and to assess if any of these markers reflects the severity of DKA.

METHODS

Our study included: 30 children with DKA (DKA group), 30 diabetic children (Non-DKA group) and 30 apparently healthy children (control group). MPV, PDW and BChE were measured in all children. Additional blood samples were withdrawn from the DKA group to assess these markers at discharge from hospital.

RESULTS

MPV, PDW and BChE were significantly altered in the DKA group than the other two groups; and their levels improved significantly at discharge of the DKA group (p < 0.05). The three markers were found to equally to predict the presence of DKA, but MPV was the most suitable risk marker for DKA diagnosis (OR = 4.251, CI 95% =1.463-12.351, p = 0.003). Regarding their relation with DKA severity, they did not correlate significantly with arterial PH or serum HCO3^- (p > 0.05).

CONCLUSION

DKA in children is associated with changes in MPV, PDW and BChE activity, which improve after resolution of the condition. Elevated MPV can be a suitable risk marker for DKA. None of the studied markers correlated with the severity of DKA.

Platelet counting

Platelet counting is a daily basic hematological analysis of crucial interest in many clinical situations. Historical manual techniques (phase-contrast microscopy) have been replaced by automated techniques (impedance or optical analyzers) more rapid and precise. More recently, flow cytometry techniques using labeled monoclonal antibodies have been proposed as reference techniques. Nevertheless, pre-analytical and analytical variables should be respected to obtain reliable results and avoid validation pitfalls.

Mean platelet volume as a diagnostic marker for cardiovascular disease: drawbacks of preanalytical conditions and measuring techniques

After the first description of platelets more than a century ago, the knowledge about their origin and function grew continuously. The development of the impedance method as a completely automated assay allowed integrating mean platelet volume (MPV) measurement as a routine parameter of the complete blood count. This enabled us to focus more on the association of platelet function and size. Since then, many authors described MPV as a marker of platelet reactivity and risk factor for cardiovascular diseases. Hence, the preanalytical variability of this parameter is known from its introduction as standard laboratory value. Unfortunately no preanalytical standards have been implemented. This review shows the high variability in the literature with MPV as a risk factor for cardiovascular disease. After a brief description of the biology of platelets, we provide an in-depth survey of the measurement methods and their drawbacks. Finally, we propose a possible approach to standardization.

Platelet function testing in clinical diagnostics

Although the utility of platelet function testing is still under debate, the necessity to inhibit platelets in patients suffering from cardiovascular and cerebrovascular disease is undoubted and well proven. The wide variety of available platelet function tests often using different methodologies, the apparent lack of standardization, and finally the emerging evidence on the clinical value of platelet function testing are resulting in a considerable uncertainty in the clinical practice, how to deal with the issue of platelet function testing. Platelet function testing might not only yield clinical benefits for the patients but also economical advantages by identifying the right drug at the right dose for the right patient. This article intends to provide an overview of the current platelet function tests such as light transmittance aggregometry, whole blood impedance aggregometry, the PFA-1001 system, the VerifyNow2 system, flow cytometry, as well as other promising technologies like Plateletworks3, IMPACT-R4, PADA, thromboelastography, and the mean platelet component (MPC), briefly addressing strengths, weaknesses and clinical utility of these tests.