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DOI: 10.1055/s-0029-1246810
Evaluation of multiple platelet function analyzer (Multiplate®) in cardiac surgery
Objectives: Variations of individual responsiveness to anti-platelet agents play a major role in perioperative bleeding in cardiac surgery. The purpose of this study was to evaluate the influence of Multiplate® function analyzer in cardiac surgery.
Methods: In an observational trial, we divided 223 consecutive patients undergoing cardiac surgery using the Multiplate® analyzer into two groups (group I=preoperative pathological Multiplate®; group II=preoperative without pathological Multiplate®). Blood samples for platelet function testing were obtained preoperatively and one hour after surgery for ASPItest, ADPtest and TRAPtest. Postoperative blood loss, requirements of blood transfusions and clinical parameters were collected until 48 hours postoperatively.
Results: Prebypass pathologic Multiplate® results were achieved in 21%, 36% and 38%, respectively. Both groups were comparable concerning pre,- and intraoperative variables. Postoperatively, there was a significant difference in transfusion of thrombocytes in both groups (ADP, p=0.03; ASPI, p=n.s.; and TRAP=0.08). In addition, there was always a difference between both groups concerning clinical parameters, like blood loss in ICU (ADP: 1443/1232 mL, ASPI: 1393/1266 mL, TRAP: 1451/1234ml), reexploration for bleeding (ADP: 7.0% vs. 2.6%; ASPI: 6.8% vs. 4.9%, TRAP: 6.3% vs. 3.7%), transfusion of RBU (ADP: 62.4% vs. 57.7%, ASPI: 61.1% vs. 60%, TRAP: 68.9% vs. 48.1%) and GFP (ADP: 16.9% vs. 13.5%, ASPI: 18.2% vs. 13.2%, TRAP: 14.8% vs. 14.5%).
Conclusion: Perioperative use of Multiplate® is a suitable periprocedural device for improved individualised anti-platelet monitoring in cardiac surgery. The possibility to improve management of hemostatic therapy with the Multiplate® analyzer is subject of further studies.