Bleeding risk assessment in patients undergoing elective cardiac surgery using ROTEM(®) platelet and Multiplate(®) impedance aggregometry

Anaesthesia
Mate PetricevicK Görlinger

Abstract

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.

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Citations

Aug 16, 2016·Anaesthesia·M PetricevicK Goerlinger
Aug 16, 2016·Anaesthesia·M D Lancé
Oct 21, 2016·Transfusion Medicine·S Agarwal
Jul 23, 2016·Journal of Cardiac Surgery·Sulman RafiqDaniel A Steinbrüchel
Sep 17, 2016·Anesthesia and Analgesia·James WinearlsJohn F Fraser
Mar 5, 2019·Platelets·Marco RanucciEkaterina Baryshnikova
Apr 2, 2019·Anaesthesia·L T S HoUNKNOWN transfusion avoidance in cardiac surgery study investigators
May 18, 2019·Korean journal of anesthesiology·Klaus GörlingerTae-Yop Kim
Jul 4, 2020·BMC Complementary Medicine and Therapies·Harald BaggerUlf Schött
Aug 6, 2020·Sensors·Sebastian D SahliAlexander Kaserer
Sep 1, 2020·Platelets·Anna Schultz-LebahnOle Halfdan Larsen
Mar 8, 2017·Anaesthesia and Intensive Care·K M Ho, W Pavey
Oct 5, 2017·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Alessandro Della CorteMarisa De Feo
Oct 27, 2018·Platelets·Marco RanucciUNKNOWN Surgical and Clinical Outcome REsearch (SCORE) group.
Dec 16, 2020·PloS One·Thiago Domingos CorrêaLeonardo José Rolim Ferraz
Aug 19, 2020·Journal of Cardiothoracic and Vascular Anesthesia·Daniel BolligerMartin Siegemund
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Jul 31, 2019·The Thoracic and Cardiovascular Surgeon·Mate PetricevicKlaus Goerlinger
Dec 11, 2021·Scandinavian Journal of Clinical and Laboratory Investigation·Anna Schultz-LebahnAnne-Mette Hvas

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