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.
journal_name
Clin Hemorheol Microcircjournal_title
Clinical hemorheology and microcirculationauthors
Di Dedda U,Ranucci M,Porta A,Bari V,Ascari A,Fantinato A,Baryshnikova E,Cotza Mdoi
10.3233/CH-180391subject
Has Abstractpub_date
2018-01-01 00:00:00pages
327-337issue
3eissn
1386-0291issn
1875-8622pii
CH180391journal_volume
70pub_type
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journal_title:Clinical hemorheology and microcirculation
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journal_title:Clinical hemorheology and microcirculation
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journal_title:Clinical hemorheology and microcirculation
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journal_title:Clinical hemorheology and microcirculation
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journal_title:Clinical hemorheology and microcirculation
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journal_title:Clinical hemorheology and microcirculation
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journal_title:Clinical hemorheology and microcirculation
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journal_title:Clinical hemorheology and microcirculation
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