Interindividual variation in platelets and the cardiovascular response to haemorrhage in the pig

The platelet count varies two-fold among healthy individuals. Considering the haemostatic role of platelets, this study evaluated the relation between cardiovascular and metabolic responses to uncontrolled haemorrhage and the pretrauma platelet count in pigs. A laceration liver injury was inflicted in 19 pigs (34 ± 3 kg; mean ± SD). To simulate a prehospital setting, fluid administration was delayed 7 min and was then by lactated Ringer. After 30 min, the fluid administered was by hydroxyethyl starch 130/0.4 to stabilize the blood volume. The platelet count for the pigs was 385 (193-507) × 10⁹/l (median (range)). The injury was similar for all pigs and caused a similar blood loss (1.4 ± 0.4 and 2.4 ± 0.4 l after administration of lactated Ringer and hydroxyethyl starch, respectively) and survival time (79 ± 17 min). At baseline, none of the cardiovascular variables were related to the pretrauma platelet count. After administration of lactated Ringer and hydroxyethyl starch, however, mean arterial pressure (R² = 0.60, P <0.001 and R² = 0.52, P <0.01), cardiac output (R² = 0.36, P <0.05 and R² = 0.84, P <0.0001), and thus oxygen delivery (R² = 0.38, P <0.05 and R² = 0.92, P <0.0001) related to the pretrauma platelet count and at 60 min, that was also the case for standard base excess (R² = 0.37, P <0.01), bicarbonate (R² = 0.44, P <0.01), and oxygen uptake (R² = 0.51, P <0.01). Following a liver trauma in pigs, the immediate cardiovascular and metabolic responses were related to the pretrauma platelet count although it did not affect the blood loss. These results support that platelets exert functions during bleeding beyond their importance for clot formation.