Dejana Bogdanic1, Nenad Karanovic2, Jela Mratinovic-Mikulandra1, Branka Paukovic-Sekulic3, Dijana Brnic4, Ivanka Marinovic5, Diana Nonkovic6, Nikolina Bogdanic7. 1. Department of Transfusion Medicine, University Hospital Center Split, Split, Croatia. 2. Department of Anesthesiology and Intensive Care, University Hospital Center Split, Split, Croatia. 3. Department of Hematology Laboratory, University Hospital Center Split, Split, Croatia. 4. Department of Diagnostic and Interventional Radiology, University Hospital Center Split, Split, Croatia. 5. Department of Physical Medicine, University Hospital Center Split, Split, Croatia. 6. Department of Epidemiology, Teaching Institute of Public Health, Split, Croatia. 7. University of Zagreb, School of Medicine, Zagreb, Croatia.
Abstract
BACKGROUND: Identifying high-risk patients for transfusion after cardiac operations would alter postoperative management. The aim of this study was to investigate closure time (CT) measured by platelet function analyzer (PFA) for prediction of bleeding and transfusions. METHODS: 66 patients were scheduled for coronary artery bypass graft (CABG) surgery and 30 patients for valve repair and replacement (non-CABG). Measurements of PFA-100® CT for collagen and adenosine diphosphate (cADP) and collagen and epinephrine (cEPI) were performed 15 min after protamine administration. Blood loss was measured, and the amount of transfusion products was recorded postoperatively. RESULTS: The study demonstrated significant differences between CABG patients with cADP-CT ≥ 118 s and those with cADP-CT < 118 s with regard to blood loss for 24 h (p = 0.001) and blood loss for 25-48 h (p = 0.003) as well as fresh frozen plasma (p = 0.015), platelet (p > 0.001) and red blood cell (p = 0.002) units given in 48 postoperative h. There were no differences cardiopulmonary bypass when was applied. In non-CABG patients, there were no differences in blood loss and transfusion requirements with respect to cADP-CT and cEPI-CT. CONCLUSION: Postoperative platelet dysfunction measured by a prolonged cADP-CT was significant predictor of blood loss and transfusion in CABG patients.
BACKGROUND: Identifying high-risk patients for transfusion after cardiac operations would alter postoperative management. The aim of this study was to investigate closure time (CT) measured by platelet function analyzer (PFA) for prediction of bleeding and transfusions. METHODS: 66 patients were scheduled for coronary artery bypass graft (CABG) surgery and 30 patients for valve repair and replacement (non-CABG). Measurements of PFA-100® CT for collagen and adenosine diphosphate (cADP) and collagen and epinephrine (cEPI) were performed 15 min after protamine administration. Blood loss was measured, and the amount of transfusion products was recorded postoperatively. RESULTS: The study demonstrated significant differences between CABG patients with cADP-CT ≥ 118 s and those with cADP-CT < 118 s with regard to blood loss for 24 h (p = 0.001) and blood loss for 25-48 h (p = 0.003) as well as fresh frozen plasma (p = 0.015), platelet (p > 0.001) and red blood cell (p = 0.002) units given in 48 postoperative h. There were no differences cardiopulmonary bypass when was applied. In non-CABG patients, there were no differences in blood loss and transfusion requirements with respect to cADP-CT and cEPI-CT. CONCLUSION: Postoperative platelet dysfunction measured by a prolonged cADP-CT was significant predictor of blood loss and transfusion in CABG patients.
Authors: Matthew J Price; James S Walder; Brian A Baker; Darell E Heiselman; Joseph A Jakubowski; Douglas K Logan; Kenneth J Winters; Wei Li; Dominick J Angiolillo Journal: J Am Coll Cardiol Date: 2012-06-19 Impact factor: 24.094
Authors: F Pappalardo; P Della Valle; G Maj; A Franco; A Lattuada; G Landoni; A Zangrillo; A D'Angelo Journal: HSR Proc Intensive Care Cardiovasc Anesth Date: 2010