The Relation Between the Platelet-Activated Clotting Test (HemoSTATUS) and Blood Loss After Cardiopulmonary Bypass

Ereth, Mark H.; Nuttall, Gregory A.; Santrach, Paula J.; Klindworth, Jacinta T.; Oliver, William C.; Schaff, Hartzell V.

doi:10.1097/00132586-199904000-00005

Cited by 7 publications

(13 citation statements)

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“…The rationale for FFP use in CPB is debatable. Long coagulation screen times correlated poorly with bleeding in CPB in one study (Gelb et al , 1996); in another a prothrombin time >12.5 s (INR not given) was moderately predictive of post‐CPB bleeding when submitted to receiver operator characteristic (ROC) analysis (Ereth et al , 1998). Giving post‐CPB FFP only if the prothrombin time is prolonged seems justifiable, but heparin, platelets and fibrinolysis — the three main actors in CPB bleeding — are unaffected.…”

Section: Ffp and Cryoprecipitate In Cpbmentioning

confidence: 99%

Cardiac bypass haemostasis: putting blood through the mill

Bevan

1999

Br J Haematol

101

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Section: Ffp and Cryoprecipitate In Cpbmentioning

confidence: 99%

Cardiac bypass haemostasis: putting blood through the mill

Bevan

1999

Br J Haematol

101

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“…Fourteen studies investigating platelet function are not presented in ►Table 5 due to low rating. 51,[53][54][55][56][57]60,62,63,[68][69][70][71]75 However, their results were generally in accordance with Antithrombotic Treatment ►Table 6 summarizes 13 studies which investigated prediction of bleeding in patients on antithrombotic medication. Eleven of these included patients undergoing cardiac surgery, 80,81,83,[85][86][87][88]91,92,94,96 and two were on orthopedic surgery.…”

Section: Resultsmentioning

confidence: 82%

“…17,44,66,97 PPVs were consistently low (ranging from 9 to 25%), although NPVs were high (ranging from 95 to 100%). 39,53,54 For children, Williams et al reported low predictive ability for preoperative platelet count and moderate for postoperative platelet count to predict postoperative bleeding. 45 Miller et al showed that post-CPB platelet count correlated independently with postoperative bleeding, 31 but the remaining studies on children found no correlations between platelet count and postoperative bleeding.…”

Section: Platelet Countmentioning

confidence: 99%

Predictive Value of Whole Blood and Plasma Coagulation Tests for Intra- and Postoperative Bleeding Risk: A Systematic Review

Larsen

Hvas

2017

Semin Thromb Hemost

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Excessive perioperative bleeding is associated with increased morbidity and mortality as well as increased economic costs. A range of whole blood laboratory tests for hemostatic monitoring has emerged, but their ability to predict perioperative bleeding is still debated. We conducted a systematic review of the existing literature assessing the ability of whole blood coagulation (thromboelastography [TEG]/thromboelastometry [ROTEM]/Sonoclot), platelet function tests, and standard plasma-based coagulation tests to predict bleeding in the perioperative setting. We searched PubMed and Embase, covering the period from 1966 to November 2016. In total, 99 original studies were included. The included studies assessed TEG/ROTEM/Sonoclot (n = 29), platelet function tests (n = 27), both test types (n = 8), and standard coagulation tests only (n = 18), and some (n = 17) investigated the predictive value of testing in patients receiving antithrombotic medication. In general, studies reported low positive predictive values for perioperative testing, whereas negative predictive values were high. The studies yielded moderate areas under receiver operator characteristics (ROC) curve (for the majority, 0.60–0.80). In conclusion, while useful in the diagnosis and management of patients with overt bleeding, whole blood coagulation and platelet function tests as well as standard coagulation tests demonstrated limited ability to predict perioperative bleeding in unselected patients. Therefore, we recommend that both whole blood and plasma-based coagulation tests are primarily used in case of bleeding and not for screening in unselected patients prior to surgery.

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“…Though some investigators have detected a relationship between prolonged BT and excessive postoperative blood loss ( 13), the template BT technique is subject to many sources of error ( 14). There is still lack of agreement as to whether other point‐of‐care measurements of platelet function would be of use in predicting post‐bypass bleeding: in a recent study, Shore‐Lesserson et al detected a substantial decrease in the use of hemostatic blood components in cardiac surgical patients when they used their thromboelastography‐guided algorithm ( 15), whereas Ereth and colleagues found no relation between platelet‐activated clotting test results and blood loss after CPB ( 16).…”

Section: Discussionmentioning

confidence: 99%