Platelet Function is Preserved After Moderate Cardiopulmonary Bypass Times But Transiently Impaired After Protamine
| العنوان: | Platelet Function is Preserved After Moderate Cardiopulmonary Bypass Times But Transiently Impaired After Protamine |
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| المؤلفون: | Törnudd, Mattias, 1974, Ramström, Sofia, Kvitting, John-Peder Escobar, Alfredsson, Joakim, Nyberg, Linnea, Björkman, Erik, Berg, Sören |
| المصدر: | Journal of Cardiothoracic and Vascular Anesthesia. 37(7):1110-1120 |
| مصطلحات موضوعية: | platelet function, flow cytometry, impedance aggegometry, protamine, cardiopulmonary bypass, cardiac surgery |
| الوصف: | Objectives: Previous studies have described impaired platelet function after cardiopulmonary bypass (CPB). Whether this is still valid in con-temporary cardiac surgery is unclear. This study aimed to quantify changes in function and number of platelets during CPB in a present-day car-diac surgery cohort. Design: Prospective, controlled clinical study. Setting: A single-center university hospital. Participants: Thirty-nine patients scheduled for coronary artery bypass graft surgery with CPB. Interventions: Platelet function and numbers were measured at 6 timepoints in 39 patients during and after coronary artery bypass graft surgery; at baseline before anesthesia, at the end of CPB, after protamine administration, at intensive care unit (ICU) arrival, 3 hours after ICU arrival, and on the morning after surgery. Measurements and Main Results: Platelet function was assessed with impedance aggregometry and flow cytometry. Platelet numbers are expressed as actual concentration and as numbers corrected for dilution using hemoglobin as a reference marker. There was no consistent impairment of platelet function during CPB with either impedance aggregometry or flow cytometry. After protamine administration, a decrease in platelet function was seen with impedance aggregometry and for some markers of activation with flow cytometry. Platelet function was restored 3 hours after arrival in the ICU. During CPB (85.0 & PLUSMN; 21 min), the number of circulating platelets corrected for dilution increased from 1.73 & PLUSMN; 0.42 & POUND; 109/g to 1.91 & PLUSMN; 0.51 & POUND; 109/g (p < 0.001). Conclusions: During cardiac surgery with moderate CPB times, platelet function was not impaired, and no consumption of circulating platelets could be detected. Administration of protamine transiently affected platelet function. & COPY; 2023 The Authors. Published by Elsevier Inc. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/) |
| وصف الملف: | electronic |
| URL الوصول: | https://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-196881 https://liu.diva-portal.org/smash/get/diva2:1791495/FULLTEXT01.pdf |
| قاعدة البيانات: | SwePub |
| تدمد: | 10530770 15328422 |
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| DOI: | 10.1053/j.jvca.2023.03.013 |