Platelet concentrates transfusion in cardiac surgery and platelet function assessment by multiple electrode...

Area of Science:

• Cardiovascular Surgery
• Hematology
• Point-of-Care Diagnostics

Background:

• Platelet dysfunction is a key factor in bleeding complications following cardiac surgery.
• Current practices lack peri-operative point-of-care monitoring for platelet function.
• Evaluating the Multiplate analyzer for risk stratification of platelet concentrate (PC) transfusion is crucial.

Purpose of the Study:

• To assess the utility of the Multiplate platelet function analyzer in identifying patients at high risk for platelet concentrate transfusion.
• To correlate platelet function parameters with the need for PC transfusion in cardiac surgery patients.

Main Methods:

• Platelet function was assessed in 60 patients using Multiplate impedance aggregometry (ADPtest, COLtest, TRAPtest) pre- and post-cardiac surgery.
• Correlations between aggregometry results and PC transfusion requirements were analyzed.
• Aggregation test results were stratified into tertiles to compare PC transfusion rates between low and high-risk groups.

Main Results:

• Lower platelet aggregation levels were significantly associated with higher rates of PC transfusion.
• Pre-operative ADPtest results predicted high total PC transfusion (AUC 0.74, P=0.001).
• Post-operative ADPtest results predicted high PC transfusion on the intensive care unit (ICU) (AUC 0.76, P=0.002).

Conclusions:

• Near-patient platelet aggregation testing can effectively identify patients at increased risk of PC transfusion.
• This monitoring is valuable both pre-operatively and upon ICU admission.
• Multiplate impedance aggregometry offers a practical approach for peri-operative risk assessment in cardiac surgery.