Relationship of fibrinolysis and platelet function to bleeding after cardiopulmonary bypass

Platelet concentrates transfusion in cardiac surgery and platelet function assessment by multiple electrode aggregometry

“…19 Among the methods of assessment of platelet function, platelet aggregation performed in whole blood or in plasma was predictive for bleeding and transfusion requirements. [12][13][14] Good correlation between the pre-operative values of ADP assessed with the Multiplate s device and the total blood transfusion during the intra-operative and the 24-h post-operative period was found in the study of Mengistu et al 14 In the study of Ray et al, 13 only patients with reduced post-operative platelet aggregation in LTA, and not in WBA, required significantly higher transfusion of blood products. No reports were made in any of these studies with regard to the type of transfused blood products.…”

“…[11][12][13] Because platelet dysfunction is among the main causes of early post-operative bleeding, but the therapy based on drainage volume is most often performed promptly and the platelet function usually recovers 12-24 after surgery, 20 it may be more useful to assess the correlation between platelet function and bleeding during the early (3-4 h) post-operative period. For this time interval, the study of Ray showed preoperative WBA and LTA, as well as post-operative LTA, to correlate with blood loss, 13 a finding that could not be reproduced by Dietrich et al 11 in their study on the predictive value of WBA for blood loss. Other methods of assessment of platelet function, like lumi-aggregometry 6 and PFA-100 s (Dade Behring, Miami, FL), also showed limited or no predictive value for post-operative blood loss.…”

“…The application of methods that assess platelet function in whole blood has been investigated, with controversial reports on their predictive value for clinical endpoints such as bleeding or transfusion requirements. [6][7][8][9][10][11][12][13][14] Multiple electrode platelet aggregometry (MEA) is a whole-blood impedance aggregometry method that allows the assessment of platelet function both in the laboratory and in the near-patient setting. The method requires no centrifugation steps and the measurements are performed in single-use test cells.…”

Post‐operative volume therapy in cardiac surgery: effects on hemostatic and circulatory variables

“…Fibrinolytic activity increases significantly during and following CPB because of intraoperative contact activation, release of tissue plasminogen activator due to kallikrein production, use of relatively high-dose heparin, and inhibition of α2-antiplasmin (Kongsgaard et al 1989, Ray et al 1994, Altman et al 1998. Antiplasmin levels do not return to normal for 48 to 72 hours postoperatively, whereas plasmin levels after discontinuation of CPB return to normal immediately (Kongsgaard et al 1989).…”

Aminocaproic or tranexamic acid in cardiac surgery: what? where? when? Literature review. Part 1

“…[17], активация фибринолиза регистрируется примерно у 2 / 3 больных во время и после операции в условиях ИК. Мно-гие исследователи [24,51] отмечают тесную корреляцию между гиперфибринолизом (ГФ) и постоперационными геморрагиями. По нашим данным, ГФ стоит на втором месте после нарушений тромбоцитарного звена гемостаза среди причин повышенной кровоточивости после опера-ций с ИК [2].…”