Platelet Transfusion in Cardiac Surgery Does Not Confer Increased Risk for Adverse Morbid Outcomes

McGrath, Tory; Koch, Colleen G.; Xu, Meng; Li, Liang; Mihaljević, Tomislav; Figueroa, Priscilla; Blackstone, Eugene H.

doi:10.1016/j.athoracsur.2008.04.051

Cited by 66 publications

(50 citation statements)

References 25 publications

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“…In a study conducted by McGrath et al [24], with 32,298 patients, no association between transfusion and increased morbidity and mortality after cardiac surgery was found. However, this study analyzed only the platelet transfusion, regardless of other hemoderivative components.…”

Section: Discussionmentioning

confidence: 99%

O impacto da hemotransfusão na morbimortalidade pós-operatória de cirurgias cardíacas

Dorneles¹,

Bodanese²,

Guaragna³

et al. 2011

Rev Bras Cir Cardiovasc

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Section: Discussionmentioning

confidence: 99%

O impacto da hemotransfusão na morbimortalidade pós-operatória de cirurgias cardíacas

Dorneles¹,

Bodanese²,

Guaragna³

et al. 2011

Rev Bras Cir Cardiovasc

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Section: Discussionmentioning

confidence: 99%

“…Haemostasis following cardiac surgery represents an ongoing clinical challenge, with cardiac surgical procedures utilising a large proportion of the blood and platelet supply in North America [1][2][3][4]. Platelet transfusion is used in an estimated 10-40% of cardiac surgical procedures, although the range of packed red blood cell use during cardiac surgical procedures is reported to be 0-80% [2][3][4][5][6][7]. The role of platelets in coagulation is complex, and involves adhesion, activation, aggregation and clot stabilisation.…”

mentioning

confidence: 99%

“…The role of platelets in coagulation is complex, and involves adhesion, activation, aggregation and clot stabilisation. Platelet dysfunction is a recognised side effect of cardiopulmonary bypass (CPB) and plays a significant role in peri-operative blood product transfusion rates [5,6,[8][9][10][11].Standard thromboelastography (TEG Ò ; Haemonetics, Braintree, MA, USA) is a point of care test that measures the rate and strength of clot formation induced by thrombin, which is used as the main platelet activator [12]. Using TEG in a point of care-guided algorithm for management of post-CPB bleeding has been shown to decrease transfusion rates in complex cardiac surgery [4].…”

mentioning

confidence: 99%

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Platelet mapping as part of modified thromboelastography (TEG^®) in patients undergoing cardiac surgery and cardiopulmonary bypass

Weitzel

Weitzel²,

Epperson³

et al. 2012

Anaesthesia

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Summary The platelet‐mapping assay of the thromboelastograph was used to measure platelet aggregation and to examine the effect of cardiopulmonary bypass on multiple platelet receptors and the role of altered receptor activity in postoperative bleeding. The percentage platelet aggregation for collagen, adenosine diphosphate and arachidonic acid was measured in 40 patients divided post‐hoc into high‐ or low‐bleeding groups depending on postoperative 24‐h chest tube output. Platelet aggregation was lower after cardiopulmonary bypass compared to before it using collagen (mean (SD) 45 (25) vs 19 (12) %, p < 0.001), adenosine diphosphate (76 (23) vs 35 (24) %, p < 0.001), and arachidonic acid (61 (33) vs 31 (35) %, p < 0.001). Only platelet aggregation as measured using collagen pre‐ and post‐cardiopulmonary bypass was significantly less in the high‐ compared to the low‐bleeding group. This finding was significantly correlated with the 24‐h chest tube drainage, and it predicted postoperative bleeding with a sensitivity of 83% and a specificity of 68%. Therefore, platelet aggregation is reduced following cardiopulmonary bypass, and this may play a role in predicting postoperative blood loss.

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“…Other studies that focused on plasma transfusions reported inconsistent findings [55,56]. Moreover, some studies reported that platelet transfusions in cardiac surgery were not independently associated with mortality [57,58], while two studies found an association between platelet transfusions and mortality [59,60]. The role of plasma and platelet transfusions in cardiac surgery complications requires further investigation.…”

Section: The Clinical Effects Of Allogeneic Leukocytes In Cardiac Surmentioning

confidence: 99%

Allogeneic leukocytes in cardiac surgery: Good or bad?

Bilgin¹,

Brand²

2011

Turk J Hematol

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Worldwide, cardiac surgery is a common procedure requiring a large quantity of allogeneic blood products, which are associated with postoperative complications. Leukocytes present in blood products may play a role in these complications, which are referred to as transfusion-related immunomodulation (TRIM). Several randomized controlled trials (RCTs) in different settings investigated the effects of allogeneic leukocytes in red blood cells (RBCs). Cardiac surgery studies reported a reduction in postoperative infections and mortality in patients that received leukocyte-reduced RBCs compared with leukocyte-containing RBCs; this was mainly due to more deaths due to infections and multiple organ dysfunction syndrome (MODS) in the group that received leukocyte-containing RBCs. Patients with postoperative complications had higher concentrations of inflammatory mediators. These findings suggest that leukocytecontaining transfusion during cardiac surgery induces a second insult to the systemic inflammatory response. In the present review we discuss the possible role of blood transfusions in cardiac surgery. Especially, we focus on the possible role of allogeneic leukocytes associated with postoperative complications after cardiac surgery. (Turk J Hematol 2011; 28: 160-9) Key words: Blood transfusions, transfusion-related immunomodulation, leukodepletion, infections, mortality, cardiac surgery (Turk J Hematol 2011; 28: 160-9) Anahtar kelimeler: Kan transfüzyonları, transfüzyon ile ilişkili immünomodülasyon, lökodeplesyon, enfeksiyonlar, mortalite, kardiyak cerrahisi

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Platelet Transfusion in Cardiac Surgery Does Not Confer Increased Risk for Adverse Morbid Outcomes

Cited by 66 publications

References 25 publications

O impacto da hemotransfusão na morbimortalidade pós-operatória de cirurgias cardíacas

O impacto da hemotransfusão na morbimortalidade pós-operatória de cirurgias cardíacas

Platelet mapping as part of modified thromboelastography (TEG^®) in patients undergoing cardiac surgery and cardiopulmonary bypass

Allogeneic leukocytes in cardiac surgery: Good or bad?

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Platelet Transfusion in Cardiac Surgery Does Not Confer Increased Risk for Adverse Morbid Outcomes

Cited by 66 publications

References 25 publications

O impacto da hemotransfusão na morbimortalidade pós-operatória de cirurgias cardíacas

O impacto da hemotransfusão na morbimortalidade pós-operatória de cirurgias cardíacas

Platelet mapping as part of modified thromboelastography (TEG®) in patients undergoing cardiac surgery and cardiopulmonary bypass

Allogeneic leukocytes in cardiac surgery: Good or bad?

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Product

Resources

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Platelet mapping as part of modified thromboelastography (TEG^®) in patients undergoing cardiac surgery and cardiopulmonary bypass