Skip to main content
SpringerLink
Log in

Platelet Function Monitoring

  • Chapter
  • First Online:
Patient Blood Management in Cardiac Surgery

  • 680 Accesses

Abstract

There are several platelet function analyzers available that can be used to assess the effect of antiplatelet drugs and the potential risk for bleeding before surgery. The systems use a variety of technologies to measure platelet function, and are based on platelet counts, impedance, or clot strength assessment. Most systems use whole blood and are point-of-care devices, which ease their implementation in the perioperative setting of cardiac surgery. Whether the systems can be used to predict perioperative bleeding is however under discussion.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 79.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 99.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 129.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Vries MJ, van der Meijden PE, Henskens YM, ten Cate-Hoek AJ, ten Cate H. Assessment of bleeding risk in patients with coronary artery disease on dual antiplatelet therapy. A systematic review. Thromb Haemost. 2016;115:7–24.

    Article  Google Scholar 

  2. Ranucci M, Baryshnikova E, Castelvecchio S, Pelissero G. Major bleeding, transfusions, and anemia: the deadly triad of cardiac surgery. Ann Thorac Surg. 2013;96:478–85.

    Article  Google Scholar 

  3. McFadyen JD, Kaplan ZS. Platelets are not just for clots. Transfus Med Rev. 2015;29:110–9.

    Article  Google Scholar 

  4. Jurk K. Analysis of platelet function and dysfunction. Haemostasis. 2015;35:60–72.

    CAS  Google Scholar 

  5. Boer C, Meesters MI, Milojevic M, et al. 2017 EACTS/EACTA guidelines on patient blood management for adult cardiac surgery. J Cardiothorac Vasc Anesth. 2017;25:1–34.

    Google Scholar 

  6. Lordkipanidze M. Platelet function tests. Semin Thromb Hemost. 2016;42:258–67.

    Article  Google Scholar 

  7. Von Beckerath N, Sibbing D, Jawansky S, et al. Assessment of platelet response to clopidogrel with multiple electrode aggregometry, the VerifyNow P2Y12 analyzer and platelet vasodilator-stimulated phosphoprotein flow cytometry. Blood Coagul Fibrinolysis. 2010;21:46–52.

    Article  Google Scholar 

  8. Mahla E, Prueller F, Farzi S, et al. Does platelet reactivity predict bleeding in patients needing urgent coronary artery bypass grafting during dual antiplatelet therapy? Ann Thorac Surg. 2016;102:2010–7.

    Article  Google Scholar 

  9. Berger PB, Kirchner HL, Wagner ES, et al. Does preoperative platelet function predict bleeding in patients undergoing off pump coronary artery bypass surgery? J Interv Cardiol. 2015;28:223–32.

    Article  Google Scholar 

  10. Van Werkum JW, Kleibeuker M, Postma S, et al. A comparison between the Plateletworks-assay and light transmittance aggregometry for monitoring the inhibitory effects of clopidogrel. Int J Cardiol. 2010;140:123–6.

    Article  Google Scholar 

  11. Marinoni M, Migliaccio ML, Trapani S, et al. Cerebral microemboli detected by transcranial Doppler in patients treated with extracorporeal membrane oxygenation. Acta Anaesthesiol Scand. 2016;6:934–44.

    Article  Google Scholar 

  12. Gurney D. Platelet function testing: from routine to specialist testing. Br J Biomed Sci. 2016;73:10–20.

    Article  Google Scholar 

  13. Morisoli AP, Gronchi F, Ferrari E, et al. The influence of drugs used in cardiac anaesthesia and critical care on multiple electrode aggregometry: an in-vitro volunteer study. Eur J Anaesthesiol. 2014;31:499–504.

    Article  CAS  Google Scholar 

  14. Kuiper G, Houben R, Wetzels RJ, et al. The use of regression analysis in determining reference intervals for low hematocrit and thrombocyte count in multiple electrode aggregometry and platelet function analyzer 100 testing of platelet function. Platelets. 2017;28:668–75.

    Article  CAS  Google Scholar 

  15. Van Poucke S, Stevens K, Wetzels R, et al. Early platelet recovery following cardiac surgery with cardiopulmonary bypass. Platelets. 2016;27:751–7.

    Article  Google Scholar 

  16. Görlinger K, Dirkmann D, Hanke AA, et al. First-line therapy with coagulation factor concentrates combined with point-of-care coagulation testing is associated with decreased allogeneic blood transfusion in cardiovascular surgery: a retrospective, single-center cohort study. Anesthesiology. 2011;115:1179–91.

    PubMed  Google Scholar 

  17. Ranucci M, Colella D, Baryshnikova E, Di Dedda U. Effect of preoperative P2Y12 and thrombin platelet receptor inhibition on bleeding after cardiac surgery. Br J Anaesth. 2014;113:970–6.

    Article  CAS  Google Scholar 

  18. Schimmer C, Hamouda K, Sommer SP, Ozkur M, Hain J, Leyh R. The predictive value of multiple electrode platelet aggregometry (Multiplate) in adult cardiac surgery. Thorac Cardiovasc Surg. 2013;61:733–43.

    Article  Google Scholar 

  19. Petricevic M, Biocina B, Konosic S, Kopjar T, Kunac N, Gasparovic H. Assessment of platelet function by whole blood impedance aggregometry in coronary artery bypass grafting patients on acetylsalicylic acid treatment may prompt a switch to dual antiplatelet therapy. Heart Vessel. 2013;28:57–65.

    Article  Google Scholar 

  20. Ranucci M, Baryshnikova E, Crapelli GB, Ranucci M, Meloni S, Pistuddi V. Electric impedance platelet aggregometry in cardiac surgery patients: a comparative study of two technologies. Platelets. 2016;27(3):185–90.

    Article  CAS  Google Scholar 

  21. Petricevic M, Konosic S, Biocina B, et al. Bleeding risk assessment in patients undergoing elective cardiac surgery using ROTEM platelet and Multiplate impedance aggregometry. Anaesthesia. 2016;71:636–47.

    Article  CAS  Google Scholar 

  22. Kong R, Trimmings A, Hutchinson N, et al. Consensus recommendations for using the Multiplate® for platelet function monitoring before cardiac surgery. Int J Lab Hematol. 2015;37:143–7.

    Article  CAS  Google Scholar 

  23. Agarwal S, Johnson RI, Kirmani BH. Pre- and post-bypass platelet function testing with multiple electrode aggregometry and TEG platelet mapping in cardiac surgery. J Cardiothorac Vasc Anesth. 2015;29:1272–6.

    Article  Google Scholar 

  24. Agarwal S, Johnson RI, Shaw M. Preoperative point-of-care platelet function testing in cardiac surgery. J Cardiothorac Vasc Anesth. 2015;29:333–41.

    Article  Google Scholar 

  25. Sivapalan P, Back AC, Ostrowski SR, Ravn HB, Johansson PI. Transfusion requirements in elective cardiopulmonary bypass surgery patients: predictive value of Multiplate and Thromboelastography (TEG) Platelet Mapping Assay. Scand J Clin Lab Invest. 2017;77:345–51.

    Article  CAS  Google Scholar 

  26. Welsh KJ, Dasgupta A, Nguyen AN, Wahed A. Utility of VerifyNow for point-of-care identification of an aspirin effect prior to emergency cardiac surgery. Ann Clin Lab Sci. 2015;45:377–81.

    CAS  PubMed  Google Scholar 

  27. Yu PJ, Cassiere HA, Dellis SL, Manetta F, Stein J, Hartman AR. P2Y12 platelet function assay for assessment of bleeding risk in coronary artery bypass grafting. J Card Surg. 2014;29:312–6.

    Article  Google Scholar 

  28. Reed GW, Kumar A, Guo J, et al. Point-of-care platelet function testing predicts bleeding in patients exposed to clopidogrel undergoing coronary artery bypass grafting: Verify pre-op TIMI 45--a pilot study. Clin Cardiol. 2015;38:92–8.

    Article  Google Scholar 

  29. Tantry US, Bonello L, Aradi D, et al. Consensus and update on the definition of on-treatment platelet reactivity to adenosine diphosphate associated with ischemia and bleeding. J Am Coll Cardiol. 2013;62:2261–73.

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Anesthesiology, Intensive Care & Perioperative Medicine, Hamad Medical Corporation, Doha, Qatar

    Marcus D. Lancé

Authors
  1. Marcus D. Lancé
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Marcus D. Lancé .

Editor information

Editors and Affiliations

  1. Vivantes Klinikum im Friedrichshain, Berlin, Germany

    Christian von Heymann

  2. Amsterdam University Medical Center, VU University, Amsterdam, The Netherlands

    Christa Boer

Rights and permissions

Reprints and permissions

Copyright information

© 2019 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Lancé, M.D. (2019). Platelet Function Monitoring. In: von Heymann, C., Boer, C. (eds) Patient Blood Management in Cardiac Surgery. Springer, Cham. https://doi.org/10.1007/978-3-030-15342-7_9

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-15342-7_9

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-15341-0

  • Online ISBN: 978-3-030-15342-7

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation