Influence of the sample anticoagulant on the measurements of impedance aggregometry in cardiac surgery

Cristina Solomon1, Michael Winterhalter1, Isabel Gilde1, Ludwig Hoy2, Andreas Calatzis3, Niels Rahe-Meyer11Department of Anesthesiology, Hannover Medical School, Hannover, Germany; 2Institute for Biometry, Hannover Medical School, Hannover, Germany; 3Department Hemostasis Transfusion Medicine, Unive...

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Autores principales:	Cristina Solomon, Michael Winterhalter, Isabel Gilde, Ludwig Hoy, Andreas Calatzis, Niels Rahe-Meyer
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2008
Materias:	Medical technology R855-855.5
Acceso en línea:	https://doaj.org/article/0e3360b306954bb4a1df98aa182273fd
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spelling	oai:doaj.org-article:0e3360b306954bb4a1df98aa182273fd2021-12-02T01:57:04ZInfluence of the sample anticoagulant on the measurements of impedance aggregometry in cardiac surgery1179-1470https://doaj.org/article/0e3360b306954bb4a1df98aa182273fd2008-10-01T00:00:00Zhttp://www.dovepress.com/influence-of-the-sample-anticoagulant-on-the-measurements-of-impedance-a2417https://doaj.org/toc/1179-1470Cristina Solomon1, Michael Winterhalter1, Isabel Gilde1, Ludwig Hoy2, Andreas Calatzis3, Niels Rahe-Meyer11Department of Anesthesiology, Hannover Medical School, Hannover, Germany; 2Institute for Biometry, Hannover Medical School, Hannover, Germany; 3Department Hemostasis Transfusion Medicine, University Hospital Munich, Munich, GermanyBackground: The standard method of assessment of platelet function is represented by light transmission aggregometry (LTA), performed in citrated platelet-rich plasma (PRP). With LTA, decrease and subsequent post-cardiopulmonary bypass (CPB) recovery of platelet function have been reported during cardiac surgery. Multiple electrode aggregometry (MEA) may be used as point-of-care method to monitor perioperative changes in platelet function. Since MEA assesses macroaggregation which is influenced by the plasmatic levels of unbound calcium, citrate may be inadequate as anticoagulant for MEA. We used citrate and heparin for MEA samples, to see with which anticoagulant the intraoperative decrease and postoperative recovery in platelet function previously described with other aggregometric methods in cardiac surgery may be observed with MEA.Methods: Blood was obtained from 60 patients undergoing routine cardiac surgery and the samples were collected in standard tubes containing unfractionated heparin (50 U/mL) or trisodium citrate (3.2%). The samples were obtained before CPB, at 30 minutes on CPB, end of CPB and on the first postoperative day. MEA was performed using the Multiplate&reg; analyzer. Collagen (COLtest, 100 &mu;g/mL) and TRAP-6 (thrombin receptor activating peptide, TRAPtest, 1mM/mL) were used as aggregation agonists.Results: Platelet aggregometric response decreased significantly during CPB. Platelet aggregation assessed using TRAP-6 as agonist on heparinized blood significantly correlated with the duration of CPB (r = &minus;0.41, p = 0.001, 2-tailed Pearson test). The aggregometric analysis performed on the first postoperative day showed a significant recovery in platelet activity in the samples containing heparin (increase from 30 &plusmn; 22 U to 46 &plusmn; 27 U for the COLtest and from 70 &plusmn; 34 U to 95 &plusmn; 32 U for the TRAPtest, p &lt;&nbsp;0.001, Student&rsquo;s t-test), while no significant recovery of platelet function could be established in the MEA measurements performed with citrated blood.Conclusions: The choice of blood sample anticoagulant used for impedance aggregometry influenced the platelet aggregation response. Postoperative platelet function recovery was only detected in the heparinized samples. Heparin seems to be better suited than citrate for the analysis of impedance aggregometry in heart surgery.Keywords: cardiac surgery, impedance aggregometry, platelet recovery, sample anticoagulant&nbsp;&nbsp; Cristina SolomonMichael WinterhalterIsabel GildeLudwig HoyAndreas CalatzisNiels Rahe-MeyerDove Medical PressarticleMedical technologyR855-855.5ENMedical Devices: Evidence and Research, Vol 2008, Iss default, Pp 23-30 (2008)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medical technology R855-855.5
spellingShingle	Medical technology R855-855.5 Cristina Solomon Michael Winterhalter Isabel Gilde Ludwig Hoy Andreas Calatzis Niels Rahe-Meyer Influence of the sample anticoagulant on the measurements of impedance aggregometry in cardiac surgery
description	Cristina Solomon1, Michael Winterhalter1, Isabel Gilde1, Ludwig Hoy2, Andreas Calatzis3, Niels Rahe-Meyer11Department of Anesthesiology, Hannover Medical School, Hannover, Germany; 2Institute for Biometry, Hannover Medical School, Hannover, Germany; 3Department Hemostasis Transfusion Medicine, University Hospital Munich, Munich, GermanyBackground: The standard method of assessment of platelet function is represented by light transmission aggregometry (LTA), performed in citrated platelet-rich plasma (PRP). With LTA, decrease and subsequent post-cardiopulmonary bypass (CPB) recovery of platelet function have been reported during cardiac surgery. Multiple electrode aggregometry (MEA) may be used as point-of-care method to monitor perioperative changes in platelet function. Since MEA assesses macroaggregation which is influenced by the plasmatic levels of unbound calcium, citrate may be inadequate as anticoagulant for MEA. We used citrate and heparin for MEA samples, to see with which anticoagulant the intraoperative decrease and postoperative recovery in platelet function previously described with other aggregometric methods in cardiac surgery may be observed with MEA.Methods: Blood was obtained from 60 patients undergoing routine cardiac surgery and the samples were collected in standard tubes containing unfractionated heparin (50 U/mL) or trisodium citrate (3.2%). The samples were obtained before CPB, at 30 minutes on CPB, end of CPB and on the first postoperative day. MEA was performed using the Multiplate&reg; analyzer. Collagen (COLtest, 100 &mu;g/mL) and TRAP-6 (thrombin receptor activating peptide, TRAPtest, 1mM/mL) were used as aggregation agonists.Results: Platelet aggregometric response decreased significantly during CPB. Platelet aggregation assessed using TRAP-6 as agonist on heparinized blood significantly correlated with the duration of CPB (r = &minus;0.41, p = 0.001, 2-tailed Pearson test). The aggregometric analysis performed on the first postoperative day showed a significant recovery in platelet activity in the samples containing heparin (increase from 30 &plusmn; 22 U to 46 &plusmn; 27 U for the COLtest and from 70 &plusmn; 34 U to 95 &plusmn; 32 U for the TRAPtest, p &lt;&nbsp;0.001, Student&rsquo;s t-test), while no significant recovery of platelet function could be established in the MEA measurements performed with citrated blood.Conclusions: The choice of blood sample anticoagulant used for impedance aggregometry influenced the platelet aggregation response. Postoperative platelet function recovery was only detected in the heparinized samples. Heparin seems to be better suited than citrate for the analysis of impedance aggregometry in heart surgery.Keywords: cardiac surgery, impedance aggregometry, platelet recovery, sample anticoagulant&nbsp;&nbsp;
format	article
author	Cristina Solomon Michael Winterhalter Isabel Gilde Ludwig Hoy Andreas Calatzis Niels Rahe-Meyer
author_facet	Cristina Solomon Michael Winterhalter Isabel Gilde Ludwig Hoy Andreas Calatzis Niels Rahe-Meyer
author_sort	Cristina Solomon
title	Influence of the sample anticoagulant on the measurements of impedance aggregometry in cardiac surgery
title_short	Influence of the sample anticoagulant on the measurements of impedance aggregometry in cardiac surgery
title_full	Influence of the sample anticoagulant on the measurements of impedance aggregometry in cardiac surgery
title_fullStr	Influence of the sample anticoagulant on the measurements of impedance aggregometry in cardiac surgery
title_full_unstemmed	Influence of the sample anticoagulant on the measurements of impedance aggregometry in cardiac surgery
title_sort	influence of the sample anticoagulant on the measurements of impedance aggregometry in cardiac surgery
publisher	Dove Medical Press
publishDate	2008
url	https://doaj.org/article/0e3360b306954bb4a1df98aa182273fd
work_keys_str_mv	AT cristinasolomon influenceofthesampleanticoagulantonthemeasurementsofimpedanceaggregometryincardiacsurgery AT michaelwinterhalter influenceofthesampleanticoagulantonthemeasurementsofimpedanceaggregometryincardiacsurgery AT isabelgilde influenceofthesampleanticoagulantonthemeasurementsofimpedanceaggregometryincardiacsurgery AT ludwighoy influenceofthesampleanticoagulantonthemeasurementsofimpedanceaggregometryincardiacsurgery AT andreascalatzis influenceofthesampleanticoagulantonthemeasurementsofimpedanceaggregometryincardiacsurgery AT nielsrahemeyer influenceofthesampleanticoagulantonthemeasurementsofimpedanceaggregometryincardiacsurgery
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Influence of the sample anticoagulant on the measurements of impedance aggregometry in cardiac surgery

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