The combined effects of the microcirculatory status and cardiopulmonary bypass on platelet count and function during cardiac surgery

Research output: Contribution to journalArticle

Abstract

BACKGROUND: Cardiac surgery with cardiopulmonary bypass is associated with important changes in the microcirculation, usually attributed to endothelial dysfunction. Another common finding of cardiac surgery is postoperative thrombocytopenia and platelet loss of function. OBJECTIVE: To investigate the association between microvascular flow pattern and postoperative changes in platelet count and function in cardiac surgery patients. METHODS: Twelve adult cardiac surgery patients received microvascular circulation (sidestream darkfield sublingual mucosa analysis) and platelet count and function (multiple electrode aggregometry ADPtest and TRAPtest) assessment before and after cardiopulmonary bypass. RESULTS: After cardiopulmonary bypass, sublingual microcirculation showed a significantly (P = 0.001) decreased microvascular flow index and increased heterogeneity index (P = 0.006). Platelet function significantly decrease after cardiopulmonary bypass both at ADPtest (P = 0.011) and TRAPtest (P = 0.002). Preoperative patterns of poor microvascular perfusion (low perfused vessels density and total vessels density) were significantly associated with lower values of post-cardiopulmonary bypass platelet function (ADPtest, P = 0.009, TRAPtest, P = 0.031) and count (P = 0.048). CONCLUSIONS: A preoperative disturbance of the microcirculation is associated with a greater postoperative platelet dysfunction. Endothelial damage, chemical and mechanical stimuli are the possible link between the two patterns.

Original languageEnglish
Pages (from-to)327-337
Number of pages11
JournalClinical Hemorheology and Microcirculation
Volume70
Issue number3
DOIs
Publication statusPublished - Jan 1 2018

Keywords

  • Cardiac surgery
  • multiple electrode aggegometry
  • platelet function
  • sublingual microcirculation

ASJC Scopus subject areas

  • Physiology
  • Hematology
  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

Fingerprint Dive into the research topics of 'The combined effects of the microcirculatory status and cardiopulmonary bypass on platelet count and function during cardiac surgery'. Together they form a unique fingerprint.

  • Cite this