CC BY-NC-ND 4.0 · J Card Crit Care 2019; 03(01): 24-27
DOI: 10.1055/s-0039-3402366
Review Article
Official Publication of The Simulation Society (TSS), accredited by International Society of Cardiovascular Ultrasound (ISCU).

Utility of Platelet Function Tests: A Recent Review Round Up

Sandeep Sharan
1  Department of Cardiac Anaesthesia, All India Institute of Medical Sciences, New Delhi, India
,
Ajay Gandhi
2  Instrumentation Laboratory India Pvt Ltd, Delhi, India
,
Poonam Malhotra Kapoor
1  Department of Cardiac Anaesthesia, All India Institute of Medical Sciences, New Delhi, India
› Author Affiliations
Further Information

Publication History

Publication Date:
06 January 2020 (online)

  

Abstract

Patients undergoing cardiac surgery are at risk of excessive bleeding and associated complications. Excessive bleeding during and after cardiac surgery has an incidence of ~20%. Massive bleeding and subsequent requirement for blood product administration and mediastinal re-exploration is associated with significant morbidity and mortality. Postoperative, nonsurgical bleeding in cardiac surgical patients is often multifactorial. Platelet dysfunction, excessive fibrinolysis, hypothermia, preoperative anemia, and deficiency of coagulation factors or their dilution are all suggested etiologies of postoperative bleeding. Among these, the most important is thought to be platelet dysfunction, which occurs as a result of the interplay of acquired and pharmacologically induced factors. Patients suffering from coronary artery disease are usually advised to stop antiplatelet medication a few days prior to coronary artery bypass grafting (CABG) to reduce the incidence of postoperative bleeding. However, patients who are still on antiplatelet drugs are at an increased risk of postoperative bleeding. Currently, the transfusion of blood and blood components to manage postoperative bleeding after CABG remains largely empirical, with considerable variation among institutions. Algorithm-based hemostatic therapy has been shown to be superior to empiric hemostatic therapy that is based on clinical judgment. Hence, there is a need to have objective tests to demonstrate platelet dysfunction before platelet transfusion. Several devices of platelet function tests have been reported in clinical studies to evaluate platelet dysfunction and quantify the need for antiplatelet therapy