THE EFFECTS OF PREOPERATIVE ASPIRIN THERAPY ON PLATELET-FUNCTION IN CARDIAC-SURGERY

被引：10

作者：

BOLDT, J

KNOTHE, C

ZICKMANN, B

HEROLD, C

DAPPER, F

HEMPELMANN, G

机构：

[1] Abteilung für Anästhesiologie und Operative Intensivmedizin, Justus-Liebig-Universität, Giessen, W-6300

[2] Abteilung für Herz- und Gefässchirurgie, Justus-Liebig-Universität, Giessen, W-6300

来源：

EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY | 1992年 / 6卷 / 11期

关键词：

CARDIAC SURGERY; ASPIRIN; PLATELET FUNCTION; AGGREGOMETRY; AORTIC VALVE REPLACEMENT; BLOOD LOSS;

D O I：

10.1016/1010-7940(92)90133-I

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Extracorporeal circulation is known to have profound effects upon platelets. Changes in platelet function were assessed in 20 patients undergoing elective coronary artery bypass grafting (CABG) who stopped taking aspirin (100 mg per day) 5-7 days before the operation compared with 20 patients undergoing aortic valve replacement (AVR) who had never taken anticoagulants or aspirin. Platelet aggregometry was carried out using the turbidimetric technique (inducing agents: adenosine diphosphate (ADP) 1.0 and 2.0 mumol/l; collagen 4 mug/ml; epinephrine 25 mumol/l), and maximum aggregation as well as the maximum gradient of aggregation were monitored before, during, and after cardiopulmonary bypass (CPB) until the 1st postoperative (p.o.) day. Until the lst p.o. day blood loss was significantly higher in the CABG (890 +/- 160 ml) than in the AVR patients (420 +/- 120 ml). A total of 8 units of packed red cells (PRC) were given in the CABG group, whereas no homologous blood was necessary in the AVR patients (P < 0.05). The aggregation variables of the CABG patients were lower than in the AVR patients as early as after the induction of anesthesia (difference in maximum aggregation ranged from 13-29%). During CPB and immediately thereafter, all aggregation variables were significantly reduced in the CABG patients (reduction in maximum aggregation ranged from - 32 to - 49%) and were significantly different from the platelet aggregation in the AVR patients. Five hours after CPB and on the lst po. day platelet aggregation in the CABG group almost returned to baseline values, however, without reaching the values of the AVR patients. It is concluded that preoperative use of aspirin in patients undergoing CABG, although withdrawn at least 7 days before the operation, was associated with a reduction in platelet aggregability combined with a higher perioperative blood loss than in patients undergoing aortic valve replacement who had never taken aspirin or anticoagulants.

引用

页码：598 / 602

页数：5

共 22 条

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