Open Access Original clinical investigation

Platelet-dependent thrombography gives a distinct pattern of in vitro thrombin generation after surgery with cardio-pulmonary bypass: potential implications

Rose Said1,2, Véronique Regnault1,2, Marie Hacquard1,3, Jean-Pierre Carteaux1 and Thomas Lecompte1,2,3,4*

Author Affiliations

1 Laboratoire d’Hématologie et Institut Cardiovasculaire Nancy, Centre Hospitalier Universitaire, Nancy, France

2 Inserm U961, Nancy Université, Nancy, France

3 EFS Lorraine Champagne, Nancy, France

4 Haematology Laboratory, CHU Nancy, Rue du Morvan, 54511, Vandoeuvre les Nancy Cedex, France

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Thrombosis Journal 2012, 10:15 doi:10.1186/1477-9560-10-15

Published: 21 August 2012

Abstract

Background

Bleeding remains a potentially lethal complication of cardio-pulmonary bypass (CPB) surgery. The purpose of this study was to obtain a better insight into in vitro thrombin generation in the context of CPB.

Methods

We used Calibrated Automated Thrombography to assess blood coagulation of 10 low-risk patients operated for valve replacement with CPB, under 2 experimental conditions, one implicating platelets as platelet dysfunction has been described to occur during CPB.

Results

Our main finding was that CPB-induced coagulopathy was differently appreciated depending on the presence or absence of platelets: the decrease in thrombin generation was much less pronounced in their presence (mean endogenous thrombin potential change values before and after CPB were -3.9% in the presence of platelets and -39.6% in their absence).

Conclusion

Our results show that experimental conditions have a profound effect in the study of in vitro thrombin generation in the context of CPB.

Keywords:
Cardio pulmonary bypass; Thrombin; Platelets; Thrombography