Multiple Electrode Aggregometry After Cardiopulmonary Bypass to Assess Platelet (Dys)-Function and Transfusion...

Area of Science:

• Cardiology
• Transfusion Medicine
• Point-of-Care Testing

Background:

• Cardiac surgery patients face a high risk of postoperative bleeding.
• Traditional reliance on platelet counts for transfusion decisions is being challenged by point-of-care platelet function tests.
• The adenosine diphosphate (ADP) test assesses platelet aggregation, offering a functional measure of platelet activity.

Purpose of the Study:

• To evaluate the impact of integrating the ADP test into clinical practice on platelet transfusion strategies in cardiac surgery.
• To compare platelet transfusion rates and patient blood loss before and after ADP test implementation.
• To examine the relationship between platelet count and ADP test results.

Main Methods:

• Retrospective, single-center observational study involving cardiac surgery patients.
• Comparison of transfusion practices between a platelet count-based algorithm (2017) and an ADP test-based algorithm (2019).
• Analysis of platelet transfusion frequency, postoperative blood loss, and reexploration rates.

Main Results:

• Moderate agreement was observed between platelet counts and ADP tests in guiding transfusions (κ = 0.483).
• Platelet transfusion rates significantly decreased from 41.82% to 13.64% after ADP test implementation (p < 0.001).
• Average postoperative blood loss was reduced in the ADP test period (300 mL vs. 440 mL, p < 0.001).

Conclusions:

• The Multiplate analyzer's ADP test can effectively reduce platelet transfusion rates in cardiac surgery.
• Point-of-care platelet function testing represents a valuable strategy for optimizing allogeneic blood product utilization.
• Further research is warranted to confirm these findings and establish optimal cutoff values for the ADP test.