A prospective pilot study of platelet function and its relationship with postoperative bleeding in pediatric cardiac surgery

Minerva Anestesiologica, 04/27/2012

Ranucci M et al. – In this pilot study, platelet function in pediatric patients undergoing cardiac surgery demonstrates a variable pattern and no association with postoperative bleeding. Confounding factors like age and cyanosis should be addressed with larger patient populations.

Methods

  • A cohort of 22 patients aged four years or less were prospectively analyzed.
  • Besides the usual coagulation tests, they were studied for platelet function at four points in time: preoperative, arrival in the intensive care unit, first and second postoperative day.
  • Platelet function was measured with multiple electrode aggregometry TRAP-test.

Results

  • After the cardiac operation there was a non-significant decrease in platelet function, with 36% of the patients demonstrating increased aggregability.
  • Platelet count demonstrated a significant (P=0.001) decrease related to the CPB duration.
  • The International Normalized Ratio (INR) was significantly (P=0.001) increased after the operation.
  • Postoperative bleeding was associated with the degree of thrombocytopenia (P=0.014), the increase in INR (P=0.001), and the prolongation of the activated partial thromboplastin time (P=0.002).

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