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Ann Thorac Surg 1994;57:981-986
© 1994 The Society of Thoracic Surgeons

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Articles

Relationship of platelet aggregation to bleeding after cardiopulmonary bypass

^a Department of Haematology and Cardiac Surgery, The Prince Charles Hospital, Brisbane, Australia
^b Department of Mathematics, University of Queensland, Queensland, Australia

Accepted for publication August 5, 1993.

^_* Address reprint requests to Mr. Ray, Haematology Department, The Prince Charles Hospital, Brisbane, 4032, Australia.

	Abstract

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Excessive bleeding after cardiopulmonary bypass operations is a persistent problem. This study assessed the influence of platelet function on blood loss for 134 patients undergoing cardiopulmonary bypass. Platelet function was measured by platelet aggregation in platelet-rich plasma and whole blood using collagen as the agonist. Adenosine triphosphate release was assessed concurrently. Measurements were made 1 day before operation and 1 hour after the cessation of cardiopulmonary bypass. Three important findings were made. First, statistically significant correlations were shown between preoperative and postoperative platelet aggregation and blood drainage for the first 3 hours postoperatively. Second, correlations were greatest when preoperative measurement was performed on whole blood and postoperative measurement was performed on platelet-rich plasma. Third, patients with reduced postoperative platelet aggregation in platelet-rich plasma had signifihours postoperatively. In defining the 16 patients who bled excessively among the 134 patients studied, the preoperative aggregation in whole blood had a sensitivity of 62%, specificity of 75%, positive predictive value of 26%, and negative predictive value of 94%. The postoperative aggregation in platelet-rich plasma had a sensitivity of 86%, spedficity of 69%, positive predictive value of 28%, and negative predictive value of 97%. These results indicate that preoperative and postoperative measurement of platelet aggregation may provide a rationale for the prophylaxis or treatment of patients to reduce blood loss after cardiopulmonary bypass.

	Footnotes

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This study was kindly supported by a grant from The Prince Charles Hospital Private Practice Study, Education and Research Trust Fund. Fisons Pharmaceuticals also assisted in the purchase of equipment for the study.

	References

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