Platelet concentrates transfusion in cardiac surgery and platelet function assessment by multiple electrode aggregometry.
Acta Anaesthesiol Scand
; 53(2): 168-75, 2009 Feb.
Article
en En
| MEDLINE
| ID: mdl-19175576
ABSTRACT
BACKGROUND:
Platelet dysfunction contributes to the pathophysiology of bleeding complications during and after cardiac surgery. In most surgical institutions, no peri-operative point-of-care monitoring of platelet function is used. We evaluated the usefulness of the Multiplate platelet function analyser based on impedance aggregometry for identifying groups of patients at a high risk of transfusion of platelet concentrates (PC).METHODS:
Platelet function parameters were determined in 60 patients before and after routine cardiac surgery. Impedance aggregometry measurements were performed on Multiplate using ADP (ADPtest), collagen (COLtest) and thrombin receptor activating peptide (TRAPtest) as platelet activators. The correlations between the aggregometry results and the transfusion of PC were calculated. The results of the aggregation tests were also divided into tertiles and the differences in PC transfusion between the low and the high tertile were assessed.RESULTS:
Low aggregometry delimited groups of patients with significantly higher PC transfusion. In the receiver operating characteristic curve, low pre-operative aggregation in the ADPtest identified patients with high total transfusion of PC (area under the curve 0.74, P=0.001), while the ADPtest performed at the end of the operation identified patients with high PC transfusion on the intensive care unit (ICU) (area under the curve 0.76, P=0.002).CONCLUSIONS:
Near-patient platelet aggregation may allow the identification of patients with enhanced risk of PC transfusion, both pre-operatively and upon arrival on the ICU.
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Pruebas de Función Plaquetaria
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Agregación Plaquetaria
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Pérdida de Sangre Quirúrgica
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Transfusión de Plaquetas
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Hemorragia Posoperatoria
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Procedimientos Quirúrgicos Cardíacos
Tipo de estudio:
Clinical_trials
/
Etiology_studies
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Prognostic_studies
/
Risk_factors_studies
Límite:
Aged
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Female
/
Humans
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Male
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Middle aged
Idioma:
En
Revista:
Acta Anaesthesiol Scand
Año:
2009
Tipo del documento:
Article
País de afiliación:
Alemania