Evaluation of the Platelet Mapping Assay on rotational thromboelastometry ROTEM.

Department of Special Anesthesiology and Pain Management, Medical University of Vienna, Vienna, Austria.
Platelets (Impact Factor: 2.63). 04/2009; 20(2):125-30. DOI: 10.1080/09537100802657735
Source: PubMed

ABSTRACT Rotational thromboelastometry ROTEM is available as point-of-care coagulation monitoring in an increasing number of European operating theatres and emergency rooms. The Platelet Mapping Assay has been described as a platelet aggregation assay for thromboelastography TEG. The aim of this experimental trial was to evaluate feasibility of the Platelet Mapping Assay on the ROTEM test system. Whole blood was drawn from 22 adult volunteers and patients with and without antiplatelet medication. Platelet aggregability was determined in three whole blood assays: the Platelet Mapping Assay using both activators arachidonic acid (AA) and adenosine diphosphate (ADP) on TEG, its adapted version on ROTEM, and the multiple electrode impedance aggregometer Multiplate. Percent aggregation inhibition results were plotted in a linear regression analysis and correlation was estimated. Sensitivity and specificity for detecting antiplatelet medication were determined. Overall correlations were statistically significant with an r(2) = 0.83 in AA-activated and an r(2) = 0.82 in ADP-activated Platelet Mapping Assay. AA-activated tests and the Multiplate analysis identified aspirin-inhibition in 86% and 100%, respectively. ADP-activated tests and the Multiplate analysis identified clopidogrel-inhibition in 67% and 89%, respectively. Specificity was low both in ROTEM and TEG. Differences in frequency distribution between the results obtained in ROTEM and TEG were not statistically significant. The Platelet Mapping Assay can be performed on the ROTEM. For the perioperative scenario, however, longer test duration and higher costs have to be considered compared to Multiplate analyses.

  • [Show abstract] [Hide abstract]
    ABSTRACT: Bleeding can be minimal, severe, life-threatening, or organ-threatening. Depending on the compensatory capacity of the patient, most bleeding events going beyond 20% blood volume may represent an emergency as well as a risk factor for anemia, transfusion, coagulopathy, and tissue hypoperfusion. All these factors are independent predictors for survival in postoperative critical care and are drivers for resource use and costs.
    Current Opinion in Critical Care 06/2014; · 3.18 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Preclinical ResearchPoint of Care testing in the perioperative arena is a high priority topic, specifically in cardiac surgery where a majority of perioperative blood transfusions occur. Platelet function in particular is of interest in cardiac surgery as cardiopulmonary bypass itself creates known platelet dysfunction, but also because more and more patients are on antiplatelet agents due to coronary stenting procedures. This review will focus on presenting current data relating to platelet function in the perioperative setting, along with a brief review of general coagulation concepts.
    Drug Development Research 11/2013; 74(7). · 0.73 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: [Table: see text] There is an increasing need for the standardization of platelet function and coagulation testing for the assessment of antithrombotic therapies. Investigators continue to strive to identify ideal laboratory testing and monitoring procedures for acquired and inherited platelet function defects as well as for evaluating patient status when treated with existing or emerging antithrombotics. These therapies are used primarily in the treatment of ischemic complications. In patients receiving antithrombotic therapy, the balance between hemostasis and thrombosis is a challenge as there is an ongoing risk for bleeding when patients are receiving antiplatelet agents or anticoagulants to lessen their risk for secondary thrombotic events. There are several diverse tests for monitoring anticoagulant therapy; however, as new agents are developed, more specific tests will be required to directly assess these agents in relationship to overall coagulation status. Research in the platelet biology field is ongoing to provide point-of-care methodologies for the assessment of platelet reactivity in terms of both bleeding and thrombosis risk. Currently there are no instruments that reliably assess the risk of bleeding. The challenges that routinely faced are the complexity of physiology, the need for standardization of platelet testing methodology, and the necessity for appropriate interpretation of the test results.
    Drug Development Research 12/2013; 74(8):587-593. · 0.73 Impact Factor
    This article is viewable in ResearchGate's enriched format