• Andinet M Mengistu, Michael W Wolf, Joachim Boldt, Kerstin D Röhm, Johannes Lang, and Swen N Piper.
• Department of Anesthesiology and Intensive Care Medicine, Klinikum Ludwigshafen, Ludwigshafen, Germany. a.mengistu@gmx.de
• J. Cardiothorac. Vasc. Anesth. 2008 Feb 1;22(1):40-6.

ObjectivesImpaired hemostasis of multiple etiologies are often present in patients undergoing cardiopulmonary bypass (CPB) surgery. Platelet dysfunction is considered to be important in the early postoperative period. Therefore, a new whole-blood platelet function analyzer was compared with thromboelastography in predicting postoperative hemostatic outcomes as measured by blood loss and blood product use.DesignProspective study.SettingTeaching hospital.ParticipantsThe study enrolled 54 patients scheduled for coronary artery bypass surgery with CPB.InterventionsCoagulation and platelet function were assessed preoperatively, after CPB, at 3 hours, and at 24 hours after surgery by using thromboelastography and impedance aggregometry. Patients were divided into a transfused and nontransfused group on the basis of postoperative transfusion requirements. Postoperative blood loss and requirements of blood transfusions were documented until 24 hours postoperatively.Measurements And Main ResultsTwenty-five patients (46%) received postoperative blood transfusions. Impaired hemostasis occurred after CPB detected by thromboelastography (p < 0.01) and impedance aggregometry (p < 0.01). In contrast to thromboelastography, preoperative adenosine diphosphate-mediated aggregometry correlated with postoperative requirements for blood transfusion (Spearman r = -0.302, p < 0.05) and was significantly lower in patients receiving allogeneic blood transfusion compared with nontransfused patients (p < 0.05). Neither aggregometry nor thromboelastography was correlated with postoperative blood loss.ConclusionImpedance aggregometry as well as thromboelastography are able to detect impaired hemostasis after CPB. In contrast to thromboelastography, aggregometry using a new whole-blood aggregometer identified patients with a reduced risk for postoperative transfusion requirements.

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