A. Vuylsteke et al., Increased pre-operative platelet counts are a possible predictor for reduced sensitivity to heparin, BR J ANAEST, 85(6), 2000, pp. 896-898
Citations number
6
Categorie Soggetti
Aneshtesia & Intensive Care","Medical Research Diagnosis & Treatment
We investigated a possible relationship between pre-operative platelet coun
t and reduced sensitivity to heparin in 87 patients undergoing cardiac surg
ery with cardiopulmonary bypass (CPB). Sensitivity to heparin was determine
d by measuring the slope of the heparin dose response (HDR) before surgery.
Pre-operative platelet counts were measured as pan of routine analysis of
the patients' coagulation status. Patients with an HDR slope of <80 s u. ml
(-1) were considered to have a reduced sensitivity to heparin and activated
clotting time data were collected from these patients before and after hep
arin administration before CPB. A significant correlation was determined be
tween pre-operative platelet levels and HDR slope (P<0.001). Platelet count
s were significantly greater in heparin-resistant patients compared with th
ose who had the expected response to the anticoagulant (P<0.05). This could
be caused by an increased capacity to produce platelet factor 4, which neu
tralizes heparin.