Predictive Factors for Platelet Number after Cardiopulmonary Bypass and Postoperative Blood Loss

Kunitomo, Ryuji; Tsurusaki, Shigeyuki; Suzuki, Ryusuke; Takaji, Kentaro; Moriyama, Shuji; Hagio, Koji; Kawasuji, Michio

doi:10.1097/00002480-200211000-00018

Cited by 4 publications

(4 citation statements)

References 16 publications

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“…14,15 Recovery of platelet function following weaning from CPB has been noted in this and other studies. 16 Kunitomo and colleagues 17 defi ned the factors determining postoperative platelet count: preoperative platelet count, age, and blood transfusions during the operation. The predictive factors for postoperative blood loss were age and amount of bleeding during surgery.…”

Section: Discussionmentioning

confidence: 99%

Using Cone and Plate(let) Analyzer to Predict Bleeding in Cardiac Surgery

Gerrah

Brill

Tshori³

et al. 2006

Asian Cardiovasc Thorac Ann

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The cone and plate(let) analyzer is an established method for assessing platelet function. It evaluates adherence of platelets on an extracellular matrix, expressed as a percentage of surface coverage and the average size of the aggregates. The purpose of this study was to determine the applicability of the cone and plate(let) analyzer in monitoring platelet function and predicting postoperative bleeding. The relationship between postoperative bleeding, perioperative platelet function, and other parameters was studied. A significant decrease in surface coverage was detected upon establishment of cardiopulmonary bypass (from 6.9% +/- 3.9% to 4.7% +/- 1.7%) with a return to preoperative values at the end of surgery. Preoperative average size and surface coverage were the only parameters that significantly and linearly correlated with postoperative bleeding. Patients with an aggregate average size < 20 microm(2) had a significantly higher incidence of severe bleeding (> 965 mL) than those with a size > 20 microm(2) (44% vs. 0%), and a higher mean blood loss (908 +/- 322 mL vs. 337 +/- 78 mL). Similar results were obtained for surface coverage < 5%, indicating the predictive value of these parameters. Preoperative platelet function as evaluated by the cone and plate(let) analyzer is an independent risk factor determining postoperative bleeding.

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Section: Discussionmentioning

confidence: 99%

Using Cone and Plate(let) Analyzer to Predict Bleeding in Cardiac Surgery

Gerrah

Brill

Tshori³

et al. 2006

Asian Cardiovasc Thorac Ann

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“…Other studies have also demonstrated the significance of low postoperative platelet count as one of the major causes of postoperative bleeding. 5,12,13,14,15 Acquired platelet dysfunction as a cause of postoperative bleeding after cardiopulmonary bypass surgery, is amplified by the extracorporeal circuit itself, hypothermia, heparin and other drugs. 6 The drop in platelet count initially may be attributed to the haemodilution by the non-blood priming solution, platelet adhesion to the circuit surfaces, platelet aggregation and activation and removal of damaged platelet by the reticulo-endothelial system.…”

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confidence: 99%

Predictors of post operative bleeding and blood transfusion in cardiac surgery

Tettey¹,

Aniteye²,

Sereboe³

et al. 2010

Ghana Medical Journal

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SUMMARYIntroduction: In spite of the recent advances in heart surgery, patients undergoing cardiac surgery with cardiopulmonary bypass are at risk of developing significant post-operative bleeding and substantial blood requirements. Objective: To evaluate the impact of some perioperative predictors of post-operative bleeding, and blood transfusion after heart surgery and offer suggestions on preventive measures. Design and Methods: A prospective analytical study. The perioperative factors studied were haemoglobin level, international normalised ratio (INR), platelet count, and total bypass time. Eighty-seven consecutive patients who underwent heart surgery in the year 2004 were selected. Each patient had laboratory work up which included full blood count, clotting profile, kidney and liver function tests. The total blood loss within the first twenty-four hours and the total units of blood transfused before the patient was discharged were also recorded. Results: Pre-operative haemoglobin was significant in determining the total units of blood received by a patient. Increasing total bypass time caused a significant increase in the percentage reduction of the pre-operative platelet count (p <0.004). However even though there was an increasing trend of post-operative bleeding with increase in total bypass time, this was not significant from the analysis (p<0.069). The percentage reduction in platelet count and immediate postoperative platelet count were significant predictors of postoperative bleeding (p <0 .009) and (p <0.003) respectively. Conclusion: Pre-operative haemoglobin, percentage reduction in the platelet count after cardiopulmonary bypass and immediate postoperative platelet count are significant predictors of postoperative bleeding and blood requirements.

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“…The incidence of postoperative thrombocytopenia is about 10-40% according to different criteria of thrombocytopenia [ 2 , 3 , 4 ] . Postoperative thrombocytopenia was reported to be associated with postoperative adverse outcomes, including acute kidney injury (AKI), stroke, and death [ 5 , 6 , 7 ] .…”

Section: Introductionmentioning

confidence: 99%

Risk Factors of Thrombocytopenia After Cardiac Surgery with Cardiopulmonary Bypass

Yan¹,

Gao²,

Lou³

et al. 2023

Braz J Cardiovasc Surg

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Introduction Postoperative thrombocytopenia is common in cardiac surgery with cardiopulmonary bypass, and its risk factors are unclear. Methods This retrospective study enrolled 3,175 adult patients undergoing valve surgeries with cardiopulmonary bypass from January 1, 2017 to December 30, 2018 in our institute. Postoperative thrombocytopenia was defined as the first postoperative platelet count below the 10 th quantile in all the enrolled patients. Outcomes between patients with and without postoperative thrombocytopenia were compared. The primary outcome was in-hospital mortality. Risk factors of postoperative thrombocytopenia were assessed by logistic regression analysis. Results The 10 th quantile of all enrolled patients (75×10 9 /L) was defined as the threshold for postoperative thrombocytopenia. In-hospital mortality was comparable between thrombocytopenia and non-thrombocytopenia groups (0.9% vs. 0.6%, P =0.434). Patients in the thrombocytopenia group had higher rate of postoperative blood transfusion (5.9% vs. 3.2%, P =0.014), more chest drainage volume (735 [550-1080] vs. 560 [430-730] ml, P <0.001), and higher incidence of acute kidney injury (12.3% vs. 4.2%, P <0.001). Age > 60 years (odds ratio [OR] 2.25, 95% confidence interval [CI] 1.345-3.765, P =0.002], preoperative thrombocytopenia (OR 18.671, 95% CI 13.649-25.542, P <0.001), and cardiopulmonary bypass time (OR 1.088, 95% CI 1.059-1.117, P <0.001) were positively independently associated with postoperative thrombocytopenia. Body surface area (BSA) (OR 0.247, 95% CI 0.114-0.538, P <0.001) and isolated mitral valve surgery (OR 0.475, 95% CI 0.294-0.77) were negatively independently associated with postoperative thrombocytopenia. Conclusion Positive predictors for thrombocytopenia after valve surgery included age > 60 years, small BSA, preoperative thrombocytopenia, and cardiopulmonary bypass time. BSA and isolated mitral valve surgery were negative predictors.

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Predictive Factors for Platelet Number after Cardiopulmonary Bypass and Postoperative Blood Loss

Cited by 4 publications

References 16 publications

Using Cone and Plate(let) Analyzer to Predict Bleeding in Cardiac Surgery

Using Cone and Plate(let) Analyzer to Predict Bleeding in Cardiac Surgery

Predictors of post operative bleeding and blood transfusion in cardiac surgery

Risk Factors of Thrombocytopenia After Cardiac Surgery with Cardiopulmonary Bypass

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