A Point-of-Care Assessment of the Effects of Desmopressin on Impaired Platelet Function Using Multiple Electrode Whole-Blood Aggregometry in Patients After Cardiac Surgery

2010 ◽  
Vol 110 (3) ◽  
pp. 702-707 ◽  
Author(s):  
Christian F. Weber ◽  
Wulf Dietrich ◽  
Michael Spannagl ◽  
Christian Hofstetter ◽  
Csilla Jámbor
Keyword(s):  
Cardiac Surgery ◽  
Platelet Function ◽  
Whole Blood ◽  
Point Of Care ◽  
Care Assessment ◽  
Whole Blood Aggregometry ◽  
Multiple Electrode

Multiple Electrode Whole-Blood Aggregometry and Bleeding in Cardiac Surgery Patients Receiving Thienopyridines

2011 ◽  
Vol 91 (1) ◽  
pp. 123-129 ◽  
Author(s):  
Marco Ranucci ◽  
Ekaterina Baryshnikova ◽  
Giorgio Soro ◽  
Andrea Ballotta ◽  
Donatella De Benedetti ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Whole Blood ◽  
Whole Blood Aggregometry ◽  
Multiple Electrode

scholarly journals Early Point-of-Care Platelet Function Testing Using Multiple Electrode Aggregometry in Patients Undergoing Cardiac Surgery

2016 ◽  
Vol 30 (6) ◽  
pp. e56-e58 ◽  
Author(s):  
Eline A. Vlot ◽  
Nanda Meents ◽  
Ewoudt M.W. van de Garde ◽  
Christian M. Hackeng ◽  
Peter G. Noordzij
Keyword(s):  
Cardiac Surgery ◽  
Platelet Function ◽  
Point Of Care ◽  
Platelet Function Testing ◽  
Multiple Electrode Aggregometry ◽  
Function Testing ◽  
Multiple Electrode

Platelet function assessed by whole-blood aggregometry in patients undergoing non-cardiac surgery

2011 ◽  
Vol 28 (5) ◽  
pp. 363-369 ◽  
Author(s):  
Anna Oscarsson ◽  
Susanne Öster ◽  
Mats Fredrikson ◽  
Tomas L Lindahl ◽  
Christina Eintrei
Keyword(s):  
Cardiac Surgery ◽  
Platelet Function ◽  
Whole Blood ◽  
Whole Blood Aggregometry

A Miniaturized Microfluidic Dielectric Sensor for Point-of-Care Assessment of Blood Coagulation

Blood ◽  
2016 ◽  
Vol 128 (22) ◽  
pp. 3754-3754 ◽  
Author(s):  
Evi X. Stavrou ◽  
Michael A. Suster ◽  
Debnath Maji ◽  
Erdem Kucukal ◽  
Ujjal Didar Singh Sekhon ◽  
...  
Keyword(s):  
Blood Coagulation ◽  
Platelet Function ◽  
Whole Blood ◽  
Point Of Care ◽  
Low Cost ◽  
Coagulation Factors ◽  
Platelet Activity ◽  
Care Assessment ◽  
Coagulation Tests ◽  
Positive Rate

Abstract Introduction: Early identification of coagulopathy has crucial clinical implications for the management of patients who are critically ill, severely injured or who are on anticoagulation therapy. Conventional laboratory-based coagulation tests are time-consuming, labor-intensive and costly. Currently available point-of-care (POC) devices are intended for use in specific patient populations (warfarin) or measurements are insensitive due to interference from the device surface. There is a growing need for a low-cost, easy-to-use, portable platform for POC assessment of the complete hemostatic process outside of the laboratory setting. Methods & Results: We have developed a novel dielectric microsensor, termed ClotChip, that is based on the fully electrical technique of dielectric spectroscopy (DS) and is sensitive to multiple coagulation factors and platelet activity, thereby allowing comprehensive blood coagulation assessment in a miniaturized, portable measurement platform (Fig 1A). ClotChip features a three-dimensional, parallel-plate, capacitive sensing structure integrated into a low-cost (material cost <$1) and disposable microfluidic biochip with miniscule sample volume (<10µL). The sensor is constructed from biocompatible and chemically inert materials (polymethyl methacrylate substrate and gold electrodes) to minimize the potential for artificial contact activation. ClotChip measurements were performed with whole blood from healthy volunteers (n=10) collected in 3.2% sodium citrate. Coagulation was induced with CaCl2. The ClotChip curves exhibited a reproducible rise to peak within 4.5 to 6 min (Tpeak; Fig 1B). Conventional coagulation tests were also performed in each of the healthy samples in duplicate and confirmed normal aPTT and PT values. ClotChip measurements were then performed in 7 clinical samples obtained from patients with coagulopathy. These patients were referred to a specialized Hematology clinic for work-up of coagulopathy. Four patients suffered from intrinsic pathway defects (2 with Hemophilia A, 3 with Hemophilia B), one patient from acquired von Willebrand (vW) factor defect and one patient from mild congenital hypo-dysfibrinogenemia (Fig 1C). Compared to the normal curve, all samples from patients with coagulopathy exhibited an abnormal curve with an extended Tpeak range of 7 to 15 minutes (p = 0.0004). An ROC curve was generated. The true positive rate was plotted against the false positive rate in Fig 1D. The Area Under the Curve for ClotChip (1.00) was higher than that of both aPTT (0.7813) and PT (0.5859), illustrating that ClotChip Tpeak parameter has superior sensitivity compared to conventional screening coagulation tests. Next, ClotChip measurements were performed with whole blood from 4 healthy donors after the samples were treated with 1µM prostaglandin E2 (PGE2) to inhibit platelet aggregation. We determined that PGE2-treated samples exhibited a statistically significant (p=0.03) lower peak height (Apeak) than that of untreated samples (Fig 1E) while Tpeak values remained unchanged between treated and untreated samples. This shows that the Apeak parameter is sensitive in response to platelet function and thatClotChip is able to detect platelet function defects. Conclusions: We have developed a novel dielectric microfluidic sensor (ClotChip) that is sensitive to multiple coagulation factors and platelet activity, thereby allowing whole blood assessment of hemostasis in a single disposable sensor. TheClotChip will bring blood coagulation testing closer to the patient for time-sensitive applications such as diagnosis of the bleeding patient and in trauma-induced coagulopathy. Disclosures No relevant conflicts of interest to declare.

Enhanced platelet aggregation and activation under conditions of hypothermia

2007 ◽  
Vol 98 (12) ◽  
pp. 1266-1275 ◽  
Author(s):  
Ruben Xavier ◽  
Ann White ◽  
Susan Fox ◽  
Robert Wilcox ◽  
Stan Heptinstall
Keyword(s):  
Cardiac Surgery ◽  
Platelet Aggregation ◽  
Platelet Function ◽  
Whole Blood ◽  
Platelet Rich Plasma ◽  
Baseline Levels ◽  
Spontaneous Aggregation ◽  
High Concentrations ◽  
Induced Aggregation ◽  
P2y12 Antagonist

SummaryThe effects on platelet function of temperatures attained during hypothermia used in cardiac surgery are controversial. Here we have performed studies on platelet aggregation in whole blood and platelet-rich plasma after stimulation with a range of concentrations of ADP, TRAP, U46619 and PAF at both 28°C and 37°C. Spontaneous aggregation was also measured after addition of saline alone. In citrated blood, spontaneous aggregation was markedly enhanced at 28°C compared with 37°C. Aggregation induced by ADP was also enhanced. Similar results were obtained in hirudinised blood. There was no spontaneous aggregation in PRP but ADP-induced aggregation was enhanced at 28°C. The P2Y12 antagonist AR-C69931 inhibited all spontaneous aggregation at 28°C and reduced all ADP-induced aggregation responses to small, reversible responses. Aspirin had no effect. Aggregation was also enhanced at 28°C compared with 37°C with low but not high concentrations of TRAP and U46619. PAF-induced aggregation was maximal at all concentrations when measured at 28°C, but reversal of aggregation was seen at 37°C. Baseline levels of platelet CD62P and CD63 were significantly enhanced at 28°C compared with 37°C. Expression was significantly increased at 28°C after stimulation with ADP, PAF and TRAP but not after stimulation with U46619. Overall, our results demonstrate an enhancement of platelet function at 28°C compared with 37°C, particularly in the presence of ADP.

Minimal invasive extracorporeal circulation preserves platelet function after cardiac surgery: a prospective observational study

Perfusion ◽  
2019 ◽  
Vol 35 (2) ◽  
pp. 138-144
Author(s):  
Helena Argiriadou ◽  
Polychronis Antonitsis ◽  
Anna Gkiouliava ◽  
Evangelia Papapostolou ◽  
Apostolos Deliopoulos ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Cardiopulmonary Bypass ◽  
Correlation Coefficient ◽  
Platelet Function ◽  
Extracorporeal Circulation ◽  
Point Of Care ◽  
Postoperative Bleeding ◽  
Minimal Invasive ◽  
Elective Cardiac Surgery ◽  
Impedance Aggregometry

Introduction: Cardiac surgery on conventional cardiopulmonary bypass induces a combination of thrombocytopenia and platelet dysfunction which is strongly related to postoperative bleeding. Minimal invasive extracorporeal circulation has been shown to preserve coagulation integrity, though effect on platelet function remains unclear. We aimed to prospectively investigate perioperative platelet function in a series of patients undergoing cardiac surgery on minimal invasive extracorporeal circulation using point-of-care testing. Methods: A total of 57 patients undergoing elective cardiac surgery on minimal invasive extracorporeal circulation were prospectively recruited. Anticoagulation strategy was based on individualized heparin management and heparin level–guided protamine titration performed in all patients with a specialized point-of-care device (Hemostasis Management System – HMS Plus; Medtronic, Minneapolis, MN, USA). Platelet function was evaluated with impedance aggregometry using the ROTEM platelet (TEM International GmbH, Munich, Germany). ADPtest and TRAPtest values were assessed before surgery and after cardiopulmonary bypass. Results: ADPtest value was preserved during surgery on minimal invasive extracorporeal circulation (58.2 ± 20 U vs. 53.6 ± 21 U; p = 0.1), while TRAPtest was found significantly increased (90 ± 27 U vs. 103 ± 38 U; p = 0.03). Postoperative ADPtest and TRAPtest values were inversely related to postoperative bleeding (correlation coefficient: −0.29; p = 0.03 for ADPtest and correlation coefficient: −0.28; p = 0.04 for TRAPtest). The preoperative use of P2Y12 inhibitors was identified as the only independent predictor of a low postoperative ADPtest value (OR = 15.3; p = 0.02). Conclusion: Cardiac surgery on minimal invasive extracorporeal circulation is a platelet preservation strategy, which contributes to the beneficial effect of minimal invasive extracorporeal circulation in coagulation integrity.

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