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Effects of fibrinogen and platelet supplementation on clot formation and platelet aggregation in blood samples from cardiac surgery patients.

Abstract：

INTRODUCTION:Bleeding after cardiac surgery may be caused by surgical factors, impaired haemostasis, or a combination of both. Transfusion of blood products is used to improve haemostasis, but little is known about what combination is optimal. We hypothesized that addition of both fibrinogen and platelets to blood samples from cardiac surgery patients would improve clot formation and platelet aggregation to a greater extent than if the components were added separately. MATERIALS AND METHODS:Increasing doses of fibrinogen concentrate (+0.5, 1.0, and 1.5 g · l(-1)) and/or platelet concentrate (+46, 92, and 138 × 10(9) platelets l(-1)) were added to postoperative blood samples from 15 cardiac surgery patients. Clot formation was assessed with rotational thromboelastometry and platelet aggregation was assessed with multiple-electrode aggregometry before and after addition of the blood products. The effects of the different additives were compared. RESULTS AND CONCLUSIONS:Ex vivo supplementation with fibrinogen or platelet concentrate resulted in significantly shortened clotting time and improved clot strength in a dose-dependent manner. Combination of fibrinogen and platelets further improved the clotting time and strength. Platelet supplementation enhanced platelet aggregation in a dose-dependent manner while fibrinogen had no or reducing effect. Combining fibrinogen and platelets improved platelet aggregation less than the use of platelets alone. In conclusion, combined platelet and fibrinogen supplementation of blood samples from cardiac surgery patients had an additive effect on clot formation compared to the individual components, but it resulted in less platelet aggregation than with platelet supplementation alone. These results may have implications for clinical transfusion protocols.

journal_name

Thromb Res

journal_title

Thrombosis research

authors

Shams Hakimi C,Fagerberg Blixter I,Hansson EC,Hesse C,Wallén H,Jeppsson A

doi

10.1016/j.thromres.2014.05.023

subject

Has Abstract

pub_date

2014-10-01 00:00:00

pages

895-900

issue

4

eissn

0049-3848

issn

1879-2472

pii

S0049-3848(14)00289-8

journal_volume

134

pub_type

杂志文章

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