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Updated: Jun 22, 2025
Microfluidics in Assessing Platelet Function
Published on: November 8, 2024
Pilot Assessment of Platelet Thrombus Area and Contractile Force in Pediatric Congenital Heart Surgery Patients Using
Alexander Wisniewski1, Anthony Norman1, Siny Tsang2
1University of Virginia, Department of Surgery, Division of Cardiothoracic Surgery, Charlottesville, VA.
Insights
Pediatric patients undergoing congenital heart disease surgery showed increased platelet thrombus area after cardiopulmonary bypass (CPB). Microfluidic testing revealed no change in platelet contractile force, but recombinant von Willebrand factor (rVWF) increased thrombus area.
Area of Science:
- Cardiovascular Surgery
- Pediatric Cardiology
- Hematology
Background:
- Congenital heart disease (CHD) surgery often requires cardiopulmonary bypass (CPB).
- CPB can impact platelet function, affecting hemostasis.
- Assessing platelet function in pediatric patients undergoing CPB is crucial.
Purpose of the Study:
- To evaluate maximum platelet contractile force and thrombus area before and after CPB in pediatric CHD patients.
- To investigate the effect of recombinant von Willebrand factor (rVWF) on platelet function post-CPB.
Main Methods:
- A prospective cohort study involving 20 pediatric CHD patients (≤8 years) was conducted.
- Microfluidic device (ATLAS PST) used to measure platelet contractile force and thrombus area.
- Blood samples collected at baseline and post-CPB; rVWF added to post-CPB samples.
Main Results:
- Maximum thrombus area increased post-CPB compared to baseline (p=0.002).
- Addition of rVWF further increased thrombus area post-CPB (p<0.001).
- Platelet contractile force did not significantly change post-CPB but increased with rVWF (p=0.044).
Conclusions:
- Microfluidic testing is feasible for assessing platelet function in pediatric CHD patients post-CPB.
- Platelet thrombus area slightly increases after CPB, with rVWF augmenting this effect.
- Further research is needed to establish clinical utility and normal values for pediatric patients.
Objectives:
This work was designed to evaluate maximum platelet contractile force and thrombus area before and after cardiopulmonary bypass (CPB) in pediatric patients having congenital heart disease (CHD) surgery using a microfluidic device.
Design:
A prospective cohort study was designed.
Setting:
The work took place at an academic medical center.
Participants:
Twenty pediatric CHD patients ≤8 years of age with expected CPB time >30 minutes were enrolled.
Interventions:
None.
Measurements And Main Results:
Blood was collected at baseline and post-CPB. Maximum platelet contractile force and thrombus area were evaluated in vitro using a microfluidic device (ATLAS PST). Post-CPB samples were supplemented with recombinant von Willebrand factor (rVWF) to explore the impact on contractile force and thrombus area. At baseline, the maximum thrombus area was 0.06 (0.05, 0.07), and the maximum force was 123.3 nN (68.4, 299.5). Linear mixed-effects regression models showed that the maximum thrombus area was larger post-CPB and post-CPB + rVWF compared with pre-CPB (estimated coefficient [Est] = 0.04, p = 0.002; Est = 0.09, p < 0.001, respectively). The maximum thrombus area was also larger post-CPB + rVWF compared with post-CPB (Est = 0.04, p = 0.001). Force was higher post-CPB + rVWF compared with pre-CPB (Est = 173.32, p = 0.044).
Conclusions:
In pediatric CHD patients, microfluidic testing demonstrated that platelet thrombus area increased slightly after CPB, while platelet contractile force did not change. In vitro addition of rVWF further increased thrombus area, suggesting augmentation of primary hemostasis. Microfluidic assessment of platelet contractile force and thrombus area in pediatric CHD patients appears feasible and can demonstrate changes after CPB. Further studies are needed to determine its accuracy, clinical utility, and normal values for pediatric patients.
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