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Does platelet size correlate with function in patients undergoing cardiac surgery?

J Boldt¹, B Zickmann, M Benson

¹Department of Anesthesiology and Intensive Care Medicine, Justus-Liebig-University Giessen, Germany.

Intensive Care Medicine

|January 1, 1993

Summary

Platelet size, measured by mean platelet volume (MPV), decreased during cardiopulmonary bypass (CPB) and correlated with impaired platelet function. MPV may indicate platelet dysfunction after cardiac surgery.

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Area of Science:

Cardiovascular Surgery
Hematology
Anesthesiology

Background:

Cardiopulmonary bypass (CPB) in cardiac surgery can lead to nonsurgical post-operative bleeding due to platelet dysfunction.
Assessing platelet function is crucial for managing bleeding risks in these patients.

Purpose of the Study:

To investigate if platelet size, specifically mean platelet volume (MPV), serves as an indicator of platelet function in patients undergoing coronary artery bypass grafting (CABG).

Main Methods:

Prospective study involving 80 patients undergoing CABG, excluding those with pre-operative coagulation disorders or recent anticoagulant use.
Platelet function assessed via aggregometry (ADP, collagen, epinephrine).
Mean platelet volume (MPV) measured using electrical conductivity; measurements taken before, during, and after CPB, including the first post-operative day.

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Main Results:

Platelet size (MPV) significantly decreased during CPB, with maximum reduction post-weaning, returning to baseline by post-operative day 1.
CPB significantly reduced platelet aggregation induced by ADP and collagen.
A significant correlation was found between changes in MPV and changes in platelet aggregation variables (ADP, collagen).

Conclusions:

Mean platelet volume (MPV) is easily measurable in the perioperative setting (OR/ICU).
MPV changes correlate with impaired platelet function following CPB.
Platelet volume may serve as a valuable indicator of platelet dysfunction in cardiac surgery patients post-bypass.