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Pre- and Post-Bypass Platelet Function Testing With Multiple Electrode Aggregometry and TEG Platelet Mapping in
Seema Agarwal1, Robert Ian Johnson1, Bilal Haneef Kirmani1
1Liverpool Heart and Chest Hospital, Liverpool, UK.
Journal of Cardiothoracic and Vascular Anesthesia
|May 20, 2015
Summary
Post-cardiac surgery platelet function tests showed reduced aggregation with adenosine diphosphate (ADP) and arachidonic acid, but not TRAP. These post-bypass tests did not predict postoperative bleeding in cardiac surgery patients.
Area of Science:
- Cardiovascular Surgery
- Hematology
- Anesthesiology
Background:
- Cardiopulmonary bypass (CPB) can affect platelet function.
- Assessing post-CPB platelet function is crucial for managing bleeding risk.
- Existing tests may not accurately predict postoperative bleeding.
Purpose of the Study:
- To compare pre- and post-CPB platelet function test results.
- To determine if post-CPB platelet function tests predict postoperative bleeding.
Main Methods:
- Prospective cohort study at a tertiary cardiothoracic center.
- Fifty-four cardiac surgery patients were enrolled.
- Platelet function was assessed pre- and post-CPB using TEG Platelet Mapping (PM) and Multiple Electrode Aggregometry (MEA) with ADP, arachidonic acid, and TRAP stimulators.
Main Results:
- Platelet aggregation significantly decreased post-CPB with ADP and arachidonic acid (p<0.01) for both MEA and PM.
- No significant change in MEA TRAP-triggered aggregation was observed (p = 0.79).
- Post-bypass platelet function did not correlate with postoperative blood loss or resternotomy rates.
Conclusions:
- Post-CPB platelet function testing reveals reduced aggregation with specific stimulators but not TRAP.
- Current post-bypass platelet function tests, as evaluated, do not reliably predict postoperative bleeding in cardiac surgery patients.
