Volume 31, Issue 1 (1-2017)                   Med J Islam Repub Iran 2017 | Back to browse issues page

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Khalaf Adeli E, Alavi S M, Alizadeh-Ghavidel A, Bakhshandeh-Abkenar H, Pourfathollah A A. Perioperative changes in platelet count and function in patients undergoing cardiac surgery . Med J Islam Repub Iran. 2017; 31 (1) :213-218
URL: http://mjiri.iums.ac.ir/article-1-4070-en.html
Blood Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine, Tehran, Iran & Departments of Immunology, Faculty of Medicine, Tarbiat Modares University of Medical Sciences, Tehran, Iran. , Pourfa@ibto.ir
Abstract:   (1823 Views)

Background: Patients undergoing cardiac surgery are at increased risk of bleeding due to multifactorial coagulopathies. In the present study, we aimed at investigating the changes in platelet count and function during and after surgery as well as determining the association of the platelet dysfunction with bleeding and transfusion requirements in these patients.
   Methods: A total of 40 adult patients scheduled for elective valve coronary cardiac surgery were included in this prospective observational study. Changes in platelet count and function with ADP, acid arachidonic, and collagen (light transmission aggregometry) were analyzed at three time points: before CPB, after CPB, and 24 hours after end of surgery. Postoperative bleeding and intraoperative transfusion requirements were recorded.
   Results: There were a significant reverse correlation between CPB time and ADP-induced aggregation, particularly after CPB and postoperative AA-induced aggregation. There was not any significant correlation between platelet count and function at all-time points. Both platelet count and platelet aggregation significantly reduced during CPB. While platelet aggregation increased on postoperative Day 1, platelet count reduced by about 40% after CPB, and remained at this level postoperatively. Patients with abnormal ADP-induced aggregation had significant increased postoperative bleeding and transfusion requirements.
   Conclusion: The results of this study demonstrate that platelet count and platelet aggregation are reduced during CPB. Our results emphasized the effect of platelet dysfunction on increased postoperative bleeding and transfusion requirements. Perioperative monitoring of platelet function can be considered as a bleeding management strategy for implantation of PBM programs. 

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Type of Study: Original Research | Subject: Cardiovascular Surgery

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