The role of platelet function analyzer-200 in predicting perioperative bleeding risk

Yu, Eun-Jeong; Jeon, Min Ji; Kang, Ka-Won; Lee, Byung Hyun; Kang, Eun Joo; Park, Yong; Lee, Se Ryeon; Sung, Hwa Jung; Choi, Chul Won; Kim, Byung Soo; Kim, Dae Sik

doi:10.3904/kjim.2019.112

Cited by 8 publications

(9 citation statements)

References 29 publications

(41 reference statements)

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“…Jeon et al [ 13 ] reported that PFA abnormalities in total knee arthroplasty were not related to postoperative bleeding. Yu et al [ 14 ] argued that PFA was useful for various surgeries in 703 patients; however, in this study, although patients with increased PFA closure time exhibited a higher rate of transfusion than those without increased PFA closure time, this was not confirmed by multivariate analysis. In this study, surgery was divided according to the surgical department, but we believe that even if it is an operation in the same area, the effect on a calculated blood loss may be different depending on the type and severity.…”

Section: Discussioncontrasting

confidence: 77%

Is the platelet function test effective in predicting blood loss in patients undergoing hepatic resection?

Gwon

Kim

2022

Ann Surg Treat Res

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Purpose The platelet function analyzer (PFA)-100/200 is widely used to assess platelet function. However, its role in predicting the perioperative risk of bleeding in patients undergoing liver resection remains controversial. Therefore, we aimed to ascertain whether the platelet function test could be useful in predicting bleeding risk in patients undergoing hepatic surgery. Methods The study participants were patients who underwent hepatectomy for hepatocellular carcinoma at our hospital over a period of 10 years from January 1, 2010 to May 31, 2020. PFA-200 values of these patients were divided into 2 groups; normal (n = 333) and prolonged (n = 39). Results There were no significant differences regarding the volumes of calculated blood loss during surgery between the normal and prolonged PFA groups (879.55 ± 1,046.50 mL vs. 819.74 ± 912.64 mL, respectively; P = 0.733); intraoperative RBC transfusion (0.52 ± 2.02 units vs. 0.26 ± 1.02 units, P = 0.419) and postoperative RBC transfusion (0.24 ± 1.17 units vs. 0.46 ± 1.97 units, P = 0.306) were similar between the 2 groups, respectively. Multivariate analysis revealed no association between PFA closure time and calculated blood loss (hazard ratio, 1.06; P = 0.881). Moreover, there was no association between PFA closure time and preoperative laboratory results or assessment of tool-related liver function in multivariate analysis. Conclusion There was no correlation between the amount of blood loss and platelet function in patients who underwent liver resection. In patients undergoing liver resection who are not managed on antiplatelet agents or do not have chronic kidney disease, the use of routine PFA is not recommended.

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Section: Discussioncontrasting

confidence: 77%

Is the platelet function test effective in predicting blood loss in patients undergoing hepatic resection?

Gwon

Kim

2022

Ann Surg Treat Res

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“…PHC (1) and PHC(2) values were calculated for all flow-obstructed curves when possible. PHC (2) was not determinable in one curve with the effect of clopidogrel (10%) and seven curves without the effect (23%) due to the lack of a reported IF. Medians were significantly different between cats with and without clopidogrel effects for TV, PHC(1), and PHC(2), but not IF (Table 2).…”

Section: Re Sultsmentioning

confidence: 99%

“…The Platelet function analyzer-200 (PFA-200, Siemens Healthineers) and its predecessor, the PFA-100, evaluate platelet function by drawing a stream of blood under vacuum (high-shear conditions) through a test cartridge containing a perforated membrane coated with platelet agonists. 1,2 The exact combination of agonists chosen depends on the purpose of platelet function testing (ie, clopidogrel monitoring, aspirin monitoring, detection of congenital disorders, etc.). As platelets interact with this membrane, blood flow slows and eventually stops.…”

Section: Introductionmentioning

confidence: 99%

Platelet function analyzer‐200 closure curve analysis and assessment of flow‐obstructed samples

Kornya

Abrams‐Ogg

Blois

et al. 2023

Veterinary Clinical Pathol

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BackgroundThe Platelet function analyzer‐200 can determine the effect of clopidogrel in cats. Flow obstruction is an error that causes uninterpretable results. Closure curves and parameters initial flow rate (IF) and total volume (TV) are displayed by the PFA‐200 and may allow interpretation of results in cases of flow obstruction. The primary hemostasis components (PHC) are calculated values that normalize these parameters.ObjectivesTo determine if closure curves and research parameters allow detecting the effect of clopidogrel in cases of flow obstruction.MethodsA review of closure curves identified those with flow obstruction and paired analysis that did not. Non‐flow–obstructed curves were used to categorize curves with respect to clopidogrel effects. IF, TV, PHC(1), and PHC(2) were evaluated to determine if these could be used to categorize if a sample exhibited the effects of clopidogrel. Curves were visually analyzed, and characteristics identified that were more common with or without the effect of clopidogrel. Visual analysis of curves was performed by blinded observers to determine if a visual analysis was able to predict the effect of clopidogrel.ResultsAnalysis of parameters was able to predict closure or non‐closure in flow‐obstructed curves. TV, PHC(1), and PHC(2) had area under the curve of the receiver operating characteristics of 0.79, 0.79, and 0.87. Visual curve analysis was unable to predict closure, with an average accuracy of only 55%, among three reviewers. Agreement between reviewers was poor (Fleiss' Kappa 0.06).ConclusionsVisual curve analysis was unable to determine the effect of clopidogrel in flow‐obstructed samples. Numerical parameters were able to detect the effect of clopidogrel with a high degree of accuracy in flow‐obstructed samples.

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“…[30] The platelet function analyzer is a sensitive assay of high-molecular-weight multimers that is advantageous because it is simple to use, requires little blood, and can be performed at the point of care. [31,32] Closure time adenosine diphosphate (CT-ADP), which is an important index assessed using the platelet function analyzer, can sensitively reflect platelet function. [33] Although the CT-ADP has poor diagnostic specificity for aVWD and is merely recognized as a screening tool, it is widely applied to assess the bleeding risk of AVS patients.…”

Section: Laboratory Assaysmentioning

confidence: 99%

Gastrointestinal bleeding during the transcatheter aortic valve replacement perioperative period: A Review

Lü

Zhang

2022

Medicine

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With the aging of the population, the incidence of senile degenerative valvular heart disease is expected to increase. Transcatheter aortic valve replacement (TAVR) has been used for patients at lower surgical risk with symptomatic severe aortic valve stenosis. Because of the improvements in TAVR technology and increasing experience of the operators, TAVR is regarded as a safe and feasible procedure. Bleeding events during the TAVR perioperative period, especially gastrointestinal (GI) bleeding, have been proven to be related to the long-term prognosis and mortality. Elderly patients with valvular heart disease are susceptible to GI bleeding because of their use of antithrombotic drugs, physical damage of coagulation factors, and GI angiodysplasia. Frequent GI bleeding and low levels of preoperative hemoglobin increase the risk of TAVR, especially for elderly patients. Because of these risks, which are easily overlooked, we should focus more attention on the perioperative management of TAVR. Reasonable screening tools, including blood examinations, risk evaluation scales, and endoscopy, are beneficial to the prevention of complications that can occur during the perioperative period. Additionally, medical therapy can safely help patients at high-risk for bleeding patients throughout the perioperative period. This study aimed to characterize the pathology of TAVR patients and discuss treatment strategies for GI bleeding during the perioperative period.

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The role of platelet function analyzer-200 in predicting perioperative bleeding risk

Cited by 8 publications

References 29 publications

Is the platelet function test effective in predicting blood loss in patients undergoing hepatic resection?

Is the platelet function test effective in predicting blood loss in patients undergoing hepatic resection?

Platelet function analyzer‐200 closure curve analysis and assessment of flow‐obstructed samples

Gastrointestinal bleeding during the transcatheter aortic valve replacement perioperative period: A Review

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