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Does the platelet function analyser (PFA-100) predict blood loss after cardiopulmonary bypass?
M Fattorutto1, O Pradier, D Schmartz
1Department of Anaesthesiology and Haematology, Hopital Erasme, 808 route de Lennik, B-1070 Brussels, Belgium. m.fattorutto@swing.be
British Journal of Anaesthesia
|April 17, 2003
Summary
The PFA-100 platelet function analyzer shows promise for identifying patients at risk of bleeding after cardiac surgery. However, it cannot reliably distinguish between low-risk and high-risk bleeding patients.
Area of Science:
- Cardiovascular Surgery
- Hematology
- Point-of-Care Diagnostics
Background:
- Assessing platelet function is crucial for managing bleeding risks in cardiac surgery.
- The PFA-100 is a novel point-of-care device designed to evaluate platelet function.
Purpose of the Study:
- To investigate the predictive capability of the PFA-100 for blood loss following cardiac surgery.
- To compare the PFA-100's performance with traditional platelet count in predicting post-operative bleeding.
Main Methods:
- Blood samples from 70 patients were analyzed using the PFA-100 before and after cardiopulmonary bypass (CPB).
- The PFA-100 measures closure time, which reflects platelet function, using collagen/ADP or collagen/epinephrine cartridges.
- Mediastinal blood loss was quantified and correlated with PFA-100 measurements.
Main Results:
- A weak correlation was found between pre-CPB collagen/epinephrine closure time and second-hour mediastinal blood loss (r=0.34, P=0.01).
- The PFA-100 demonstrated comparable sensitivity and positive predictive value to platelet count in identifying excessive bleeding post-CPB (75% vs. 100% sensitivity, 27% vs. 25% PPV).
Conclusions:
- The PFA-100 is a viable test for identifying patients at risk of excessive bleeding after CPB.
- The PFA-100's ability to differentiate between low and substantial bleeding risk was limited.