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Shear-induced pathway of platelet function in cardiac surgery
N Tabuchi1, I Tigchelaar, W van Oeveren
1Dept of Blood Interaction Research, Cardiopulmonary Surgery, University Hospital, Groningen, The Netherlands.
Seminars in Thrombosis and Hemostasis
|January 1, 1995
Summary
Platelet dysfunction significantly impairs hemostasis after cardiac surgery, with a novel in-vitro bleeding test correlating dysfunction to blood loss. This suggests the test aids in diagnosing and treating post-operative bleeding.
Area of Science:
- Cardiovascular Surgery
- Hematology
- Platelet Physiology
Background:
- Impaired hemostasis is a complication after cardiac surgery.
- The role of platelet dysfunction in this complication is not fully understood due to a lack of sensitive assessment methods.
Purpose of the Study:
- To investigate changes in platelet function during cardiopulmonary bypass using a novel shear-inducing technique.
- To determine the contribution of impaired platelet function to post-operative bleeding after cardiac surgery.
Main Methods:
- Utilized the in-vitro bleeding test (Thrombostat 4000), a novel shear-inducing technique, to assess platelet function.
- Monitored platelet function in patients undergoing cardiac surgery with cardiopulmonary bypass.
- Correlated platelet function measurements with blood loss from chest drains.
Main Results:
- Platelet function was rapidly impaired after initiating cardiopulmonary bypass, with partial recovery by the end of the procedure.
- Aspirin-treated platelets showed more severe dysfunction compared to non-aspirin platelets during cardiopulmonary bypass.
- The degree of platelet dysfunction at the end of surgery, not platelet count or activated clotting time, significantly correlated with post-operative blood loss.
Conclusions:
- Cardiopulmonary bypass significantly affects the shear-induced pathway of platelet function.
- Impaired platelet function is a major contributor to excessive bleeding after cardiac surgery.
- Routine use of shear-inducing tests can aid in diagnosing and managing bleeding complications.