Platelet function test HemoSTATUS 2: tool or toy for an optimized management of hemostasis?
BACKGROUND
Bleeding after open heart surgery is a common but unintended problem, which is unequivocally related to platelet function. The target of our study was to correlate platelet activation levels and postoperative blood loss as well as the predictive power of measurements focusing on postoperative hemostasis.


METHODS
The prospective trial comprised 100 patients (mean age: 64.3 years, 68% male) undergoing cardiac surgery. Platelet activation was measured by the new and modified HemoSTATUS test. Blood samples were drawn pre-, intra- and postoperatively. Standard hemostasis tests, including activated clotting time (ACT), partial thromboplastin time (PTT), hemoglobin, platelet count, antithrombin III (AT III) and fibrinogen, were measured according to the clinical routine. Blood loss and consumed blood products were documented up to the 24th hour after the operation.


RESULTS
Platelet activation showed a typical change, with lowest levels after the end of extracorporeal circulation and a restitution to preoperative levels after 24 h. Mean blood loss was 461 ml. Statistical analysis showed neither a correlation to the platelet activation measurements nor to low pre-, intra- or postoperative levels.


CONCLUSIONS
The HemoSTATUS platelet function test is not suitable for a reliable monitoring of platelet pathophysiology and patient outcome after extracorporeal circulation. Furthermore, no correlation of preoperative platelet activation and blood loss could be shown.
Isgro
Frank
F
Clinic for Heart Surgery, Heartcenter Ludwigshafen, Germany.
Rehn
Erik
E
Kiessling
Arndt-H
AH
Kretz
Kai-U
KU
Kilian
Wolfgang
W
Saggau
W
W
D000368:Aged; D000369:Aged, 80 and over; D001780:Blood Coagulation Tests; D016063:Blood Loss, Surgical; D002315:Cardiopulmonary Bypass / Q000009:adverse effects*; D005260:Female; D006487:Hemostasis; D006801:Humans; D008297:Male; D008875:Middle Aged; D015539:Platelet Activation / Q000502:physiology*; D010979:Platelet Function Tests / Q000295:instrumentation; D019106:Postoperative Hemorrhage / Q000175:diagnosis* / Q000209:etiology; D011237:Predictive Value of Tests; D011446:Prospective Studies