Early alterations in platelet mitochondrial function are associated with survival and organ failure in patients with septic shock

Michael A. Puskarich, Jeffrey A. Kline, John A. Watts, Kristin Shirey, Jonathan Hosler, Alan E. Jones

Research output: Contribution to journalArticlepeer-review

33 Scopus citations


Introduction The objective of the study is to determine if changes in platelet mitochondrial function in patients with sepsis are present early after presentation and the association of these changes with clinical outcomes and systemic metabolic function. Materials and methods This is a prospective observational cohort study of a convenience sample of patients with severe sepsis. Mitochondrial function of intact, nonpermeabilized platelets suspended in their own plasma was estimated using high-resolution respirometry. Unstimulated basal respiration, oligomycin-induced state 4, and maximal respiratory rate after serial titrations of carbonyl cyanide 4-(trifluoromethoxy) phenylhydrazone were measured. Organ failure was estimated using Sequential Organ Failure Assessment score, and patients were followed up until 28 days to determine survival. Lactate levels were measured in all patients, and a subset of patients had lactate/pyruvate (L/P) ratios measured. Results Twenty-eight patients were enrolled, 21 of whom survived. Initial Sequential Organ Failure Assessment score and lactate levels were 8.5 (interquartile range [IQR], 6-10) and 2.3 (IQR, 1.2-3.5) respectively, whereas the median L/P ratio was 23.4 (IQR, 15.2-38). Basal and maximal respiratory rates were significantly higher among nonsurvivors compared to survivors (P =.02 and P =.04), whereas oligomycin-induced state 4 respiration was not statistically different between groups (P =.15). We found a significant association between maximal respiration and organ failure (P =.03) and both basal and maximal rates with initial lactate level (P =.04, P =.02), but not with L/P ratio. Conclusions Differences in platelet mitochondrial function between survivors and nonsurvivors are present very early in the hospital course and are associated with organ failure and lactate.

Original languageEnglish (US)
Pages (from-to)63-67
Number of pages5
JournalJournal of Critical Care
Issue number1
StatePublished - Feb 1 2016
Externally publishedYes

Bibliographical note

Funding Information:
This study was supported by an Emergency Medicine Foundation Career Development Award and a University of Mississippi Medical Center Intramural Research Support Program grant. Dr Puskarich has received salary support through the NIH K23-GM113041-01. Dr Jones is supported by 1R01GM103799-01 from the National Institute of General Medical Sciences/National Institutes of Health. The sponsors had no role in the design, conduct, interpretation, or writing of the study.

Publisher Copyright:
© 2015 Elsevier Inc.


  • Lactate
  • Metabolism
  • Oxygen consumption
  • Pyruvate
  • Sepsis


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