The following is a summary of “Platelet Bioenergetics and Associations With Delirium and Coma in Patients With Sepsis,” published in the April 2024 issue of Critical Care by Onyemekwu et al.
Sepsis triggers brain dysfunction (delirium or coma), potentially due to altered metabolism, highlighting the need to study bioenergetics for better understanding.
Researchers conducted a retrospective study determining if platelet mitochondrial energy production changes correlate with acute brain dysfunction in sepsis.
They enrolled participants with critical illness admitted to the ICU and employed validated assessment tools to diagnose delirium or coma. Blood samples were obtained and processed to isolate platelets, followed by measurement of their mitochondrial oxygen consumption using Seahorse extracellular flux technology. The technique directly assessed the baseline respiration, proton leak, maximal oxygen consumption, and extracellular acidification rate. The derived measures, such as ATP-linked respiration, spare respiratory capacity, and non-mitochondrial oxygen consumption rate, were calculated from the obtained data.
The results showed that patients in coma had higher oxygen consumption, spare respiratory capacity, and increased extracellular acidification rates. After adjusting for confounding variables such as age and sedation, a modified Sequential Organ Failure Assessment score without the neurologic component, preexisting cognitive function, and increased spare respiratory capacity remained significantly higher in the coma group than in the controls. A potential link between increased spare respiratory capacity in platelets and coma during sepsis was observed, while delirium did not show any association with the measured mitochondrial bioenergetic parameters.
Investigators concluded that increased spare respiratory capacity in platelets associated with coma in patients with sepsis, warranting further investigation into delirium and mitochondrial function.
Source: chestcc.org/article/S2949-7884(24)00030-3/fulltext#%20
