Bleeding risk assessment in patients undergoing elective cardiac surgery using ROTEM® platelet and Multiplate® impedance aggregometry

Summary Impaired platelet function is a major risk factor for peri‐operative bleeding and transfusion. This prospective, observational study enrolled 101 consecutive patients undergoing elective cardiac surgery with cardiopulmonary bypass. Platelet function was assessed by two whole blood impedance...

Full description

Saved in:

Bibliographic Details
Published in:	Anaesthesia Vol. 71; no. 6; pp. 636 - 647
Main Authors:	Petricevic, M., Konosic, S., Biocina, B., Dirkmann, D., White, A., Mihaljevic, M. Z., Ivancan, V., Konosic, L., Svetina, L., Görlinger, K.
Format:	Journal Article
Language:	English
Published:	England Blackwell Publishing Ltd 01-06-2016
Subjects:	Aged Aged, 80 and over bleeding management cardiac surgery Cardiac Surgical Procedures - adverse effects cardiopulmonary bypass Chest Tubes Drainage Elective Surgical Procedures - adverse effects Female Humans impedance aggregometry Male Middle Aged multiple electrode aggregometry Platelet Aggregation Postoperative Hemorrhage - etiology Risk Assessment cardiopulmonary bypass cardiac surgery impedance aggregometry multiple electrode aggregometry bleeding management
Online Access:	Get full text
Tags:	Add Tag No Tags, Be the first to tag this record!

Description
Summary:	Summary Impaired platelet function is a major risk factor for peri‐operative bleeding and transfusion. This prospective, observational study enrolled 101 consecutive patients undergoing elective cardiac surgery with cardiopulmonary bypass. Platelet function was assessed by two whole blood impedance aggregometers (ROTEM® platelet and Multiplate®), using three different activators (arachidonic acid, adenosine diphosphate and thrombin receptor‐activating peptide‐6), at three peri‐operative time points (before anaesthesia, after aortic declamping and 5–10 min after protamine administration). Platelet function was impaired over the time‐course in all assays. Results after protamine administration demonstrated the best correlation with postoperative chest tube drainage. Patients with a chest tube drainage exceeding the 75th percentile of the entire study population, during the first 24 postoperative hours, were characterised to have excessive bleeding. Both devices provided similar predictability for postoperative chest tube drainage and red blood cell transfusion requirements. The latter was associated with the degree of platelet inhibition and the number of pathways inhibited determined respective cut‐off values.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0003-2409 1365-2044
DOI:	10.1111/anae.13303