[Therapeutic options for perioperatively acquired platelet dysfunctions]

Area of Science:

• Hematology
• Anesthesiology
• Surgical Hemostasis

Context:

• Acquired platelet function disorders contribute to peri-operative bleeding.
• Conventional coagulation tests and platelet counts do not adequately detect impaired platelet function.
• Retrospective studies suggest a need for bedside platelet function testing.

Purpose:

• To highlight the clinical significance of acquired platelet dysfunction in surgical settings.
• To advocate for the implementation of point-of-care platelet function assays.
• To explore pharmacological alternatives to platelet transfusions for managing bleeding.

Summary:

• Increased surgical blood loss is often linked to acquired platelet function disorders.
• Bedside tests for platelet function are desirable due to the limitations of standard coagulation analyses.
• Pharmacological agents like desmopressin (DDAVP) and tranexamic acid, after optimizing hemostatic conditions, present cost-effective options with fewer side effects than platelet transfusions.

Impact:

• Improved detection and management of bleeding complications in surgical patients.
• Potential reduction in the need for platelet transfusions, lowering costs and risks.
• Enhanced patient safety through better peri-operative hemostasis control.