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Anwendungsbeobachtung der Multiplate®­Impedanzaggregometrie in Bezug auf den postoperativen Transfusionsbedarf bei kardiochirurgischen Operationen mit intraoperativem Anschluss an eine Herz­Lungen­Maschine

Use of the Multiplate® Method in Cardiothoracic Surgery with intraoperative Cardio-Pulmonary Bypass with respect to postoperative Transfusion Requirements

Nora Freifrau von Saß
Doctoral thesis
Date of Examination: 2016-11-21
Date of issue: 2016-11-09
Advisor: Winterhalter, Michael Prof. Dr.
Referee: Winterhalter, Michael Prof. Dr.
Referee: Riggert, Joachim PD Dr.
Referee: Mausberg, Rainer Prof. Dr.

Persistent Address: http://hdl.handle.net/11858/00-1735-0000-002B-7C96-2

 

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Abstract

English

The Multiplate® System as a Point of Care method allows a standardised detection of a deficiency in platelet function in the intraoperative setting. This observational study evaluated the alteration in platelet function, as detected by the Multiplate® System, in on-pump cardiac surgeries and its predictive value with respect to postoperative transfusion demands. The study cohort consists of 82 patients. At three specific times during surgery (induction of anaesthesia, release of aortic cross clamp and after Protamine) blood samples were taken and analysed. In summary, the Multiplate® method showed a predicitive aspect with concerning administered units of Fresh Frozen Plasma, Platelet Transfusions and Coagulation Factors (PPSB and Fibrogammin) in the postoperative setting. There was no predictive aspect with respect to the postoperative administration of Packed Red Blood Cells. A combination of TRAP AUC and standard coagulation tests (PTT, Quick - Value, Fibrinogen, Thrombin-Time) can help to determine postoperative transfusion requirements.
Keywords: Multiplate® Method; on-pump cardiac surgeries; TRAP AUC; postoperativeTransfusions
Schlagwörter: Multiplate-Impedanzaggregometrie; kardiovaskuläre Operationen mit intraoperativen Anschluss an die Herz-Lungen-Maschine; POC-Methode; postoperativer GFP- und TK-Transfusionsbedarf
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