Platelet Function Testing Using Sonoclot and TEG6s as a Platelet Transfusion Prediction Tool in Open Heart Surgery

Area of Science:

• Cardiovascular Surgery
• Anesthesiology
• Hematology

Background:

• Point-of-care testing (POCT) aids blood coagulation management in cardiovascular surgery.
• Thromboelastography (TEG6s) offers benefits for blood transfusion in cardiac surgery.
• Sonoclot analysis requires further validation, particularly for platelet function (PF).

Purpose of the Study:

• To evaluate Sonoclot's accuracy for platelet concentrate (PC) transfusion compared to TEG6s.
• To assess Sonoclot's platelet function (PF) parameter as a transfusion guide.
• To compare intraoperative PC volume and end-of-surgery platelet counts between Sonoclot and TEG6s.

Main Methods:

• A single-center, prospective, randomized trial involving 42 adult patients undergoing elective cardiac surgery.
• Patients were randomized into Sonoclot (S) or Sonoclot and TEG6s (ST) groups.
• PC transfusion guided by POCT parameters at protamine administration; correlation between PF and platelet count investigated.

Main Results:

• No statistically significant difference in intraoperative PC volume between Sonoclot and TEG6s groups.
• Sonoclot PF parameter showed a moderate correlation with end-of-surgery platelet count (r=0.5449, p=0.009).
• TEG6s PF parameter demonstrated a strong correlation with end-of-surgery platelet count (r=0.7744, p<0.001).

Conclusions:

• Sonoclot and TEG6s did not show statistically significant differences in platelet transfusion volume.
• Sonoclot's PF parameter exhibited a moderate correlation with platelet count.
• Sonoclot's PF may serve as a potential indicator for platelet function monitoring in cardiovascular surgery.