Bleeding risk assessment in patients undergoing elective cardiac surgery using ROTEM®platelet and Multiplate®impedance aggregometry
| Autor: | Lucija Konosic, Mate Petricevic, Sanja Konosić, M. Z. Mihaljevic, Klaus Görlinger, Visnja Ivancan, Daniel Dirkmann, Lucija Svetina, Bojan Biocina, A. White |
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| Rok vydání: | 2016 |
| Předmět: |
Male
Excessive Bleeding medicine.medical_specialty Platelet Aggregation Medizin Postoperative Hemorrhage 030204 cardiovascular system & hematology Risk Assessment law.invention 03 medical and health sciences 0302 clinical medicine Thrombin 030202 anesthesiology law Internal medicine medicine Cardiopulmonary bypass Humans Platelet Cardiac Surgical Procedures Risk factor Aged Whole blood Aged 80 and over biology business.industry bleeding cardiac surgery platelet function Middle Aged Protamine Cardiac surgery Anesthesiology and Pain Medicine Elective Surgical Procedures Chest Tubes Anesthesia Cardiology biology.protein Drainage Female business medicine.drug |
| Zdroj: | Anaesthesia. 71:636-647 |
| ISSN: | 0003-2409 |
| Popis: | Impaired platelet function is a major risk factor for peri-operative bleeding and transfusion. This prospective, observational study enrolled 101 consecutive patients undergoing elective cardiac surgery with cardiopulmonary bypass. Platelet function was assessed by two whole blood impedance aggregometers (ROTEM(®) platelet and Multiplate(®) ), using three different activators (arachidonic acid, adenosine diphosphate and thrombin receptor-activating peptide-6), at three peri-operative time points (before anaesthesia, after aortic declamping and 5-10 min after protamine administration). Platelet function was impaired over the time- course in all assays. Results after protamine administration demonstrated the best correlation with postoperative chest tube drainage. Patients with a chest tube drainage exceeding the 75th percentile of the entire study population, during the first 24 postoperative hours, were characterised to have excessive bleeding. Both devices provided similar predictability for postoperative chest tube drainage and red blood cell transfusion requirements. The latter was associated with the degree of platelet inhibition and the number of pathways inhibited determined respective cut-off values. |
| Databáze: | OpenAIRE |
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