Cardiopulmonary bypass induces significant platelet activation in children undergoing open-heart surgery

Guay, Joanne; Ruest, Pierre; Lortie, Louise

doi:10.1097/00003643-200412000-00005

Cited by 22 publications

(14 citation statements)

References 21 publications

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“…The reduction in platelet function after ADP stimulation has been observed quite consistently, whereas the response to collagen has been observed both to decrease and remain stable like in the present study . The variation observed in platelet function in previous published papers, with both increases and decreases, is probably also related to variability in methods for platelet assessment, age, and surgery heterogeneity among the pediatric patients included . One of the important advantages of ROTEM ® and Multiplate ® Analyzer is the fact that evaluation is carried out in whole blood, implying inclusion of the cellular part of hemostasis.…”

Section: Discussionmentioning

confidence: 99%

Marked changes in platelet count and function following pediatric congenital heart surgery

Andreasen

Hvas

Ravn

2014

Pediatric Anesthesia

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Section: Discussionmentioning

confidence: 99%

Marked changes in platelet count and function following pediatric congenital heart surgery

Andreasen

Hvas

Ravn

2014

Pediatric Anesthesia

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“…3 19 In contrast, studies of perioperative platelet function have given conflicting results. Guay and colleagues 20 and Ranucci and colleagues 21 reported increased platelet reactivity, whereas Hofer and colleagues 16 and Ichinose and colleagues 22 reported reduced function during and after paediatric cardiac surgery. The diverging results may be consequences of the multifaceted paediatric cardiac surgery in patients with immature coagulation systems, of complex surgical procedures, and of the range of patients (cyanotic-acyanotic, neonates, older children, etc.)…”

Section: Discussionmentioning

confidence: 99%

Platelet count and function in paediatric cardiac surgery: a prospective observational study

Romlin

Söderlund

Wåhlander

et al. 2014

British Journal of Anaesthesia

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“…Platelet predonation and reinfusion is an elegant technique to decrease bypass induced-platelet activation. 62,64 Erythropoietin with red blood cell predonation could be helpful in acyanotic heart disease. 55 The addition of fresh frozen plasma to the pump prime could possibly help children with cyanotic heart disease and those with complex surgery, but the risk of transmitting infectious diseases must be weighed against the potential benefits.…”

mentioning

confidence: 99%

Réduire les pertes sanguines et les besoins transfusionnels en chirurgie pédiatrique

Guay

Moerloose

Lasne

2006

Can J Anesth/J Can Anesth

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Purpose: To summarize the physiology and pathophysiology relevant to perioperative blood loss in children. Strategies to reduce blood losses are reviewed. Methods:The literature was reviewed using the electronic library PUBMED and the Cochrane Database of Systematic Reviews. Relevant studies published in English or French with an English abstract are included. The following keywords were used: children, blood transfusion, surgical blood loss, erythropoietin, autologous blood, red blood cell saver, normovolemic hemodilution, desmopressin, aminocaproic acid, tranexamic acid, aprotinin, cardiac surgery, liver transplantation and scoliosis surgery. Main findings:For patients with idiopathic scoliosis, predonation with or without the addition of erythropoietin is a safe and effective way to avoid the use of allogenic blood products. For open heart procedures: whole blood of less than 48 hr is helpful for children of less than two years of age undergoing complex procedures; tranexamic acid may be helpful for cyanotic heart disease and, to a lesser degree, for reoperations; while antikallikrein blood levels of aprotinin may both reduce the need for allogenic blood transfusions and improve postoperative oxygenation in infants. Conclusion:Reducing perioperative allogenic blood transfusions is possible in pediatric patients provided that prophylactic measures are adapted to age, disease and type of surgery. I N normal children perioperative blood loss leading to administration of allogenic transfusion may be encountered if: the surgical site does not allow easy access to surgical hemostasis, the surgery is performed on highly vascularized tissues that are not easily sutured or cauterized (for example bone elements such as in spinal fusion or correction of craniosynostosis) or the surgery itself induces various disturbances of hemostasis (dilution of factors and induction of fibrinolysis as in cardiac surgery with the use of extracorporeal bypass). The pathology justifying the surgical procedure may also induce various coagulation and/or hemostatic abnormalities. Children suffering from congenital cardiac or liver dis- ease may have thrombocytopenia, abnormal platelet function (congenital heart disease) and/or inadequate amounts of various coagulation factors. Objectif1 Perioperative management of children with congenital coagulation and hemostatic diseases will not be discussed in this review. Developmental aspects of hemostasisAn excellent summary of the developmental physiology of coagulation, based mainly on the extensive work of Maureen Andrew, may be found in a recent review by Kuhle et al. and is summarized in Table I.2 Since maternal coagulation factors do not cross the placental barrier, blood levels measured at birth are the result of fetal synthesis that starts around the fifth week of gestation. Fetal blood becomes clottable around 11 weeks of gestation. Except fetal fibrinogen which has an increased content of sialic acid, all coagulation and inhibitor factors are qualitatively normal at birth, and differ from...

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Cardiopulmonary bypass induces significant platelet activation in children undergoing open-heart surgery

Cited by 22 publications

References 21 publications

Marked changes in platelet count and function following pediatric congenital heart surgery

Marked changes in platelet count and function following pediatric congenital heart surgery

Platelet count and function in paediatric cardiac surgery: a prospective observational study

Réduire les pertes sanguines et les besoins transfusionnels en chirurgie pédiatrique

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