Bleeding in cardiac surgery carries a high mortality and is more frequent in case of coagulopathy. Goal-directed hemostatic therapy is widely accepted to be associated with reduced bleeding volume and allogeneic blood transfusion requirements, possibly thereby improving outcomes in cardiac surgery. We performed a prospective, single-center, observational study investigating the analytical accuracy and feasibility of the coagulation device "CoaguCheck" (COGC) for point-of-care monitoring of blood coagulation profiles in the operating room in patients undergoing on-pump cardiovascular surgery. With ethical committee approval, 31 consecutive patients were recruited for the study. At 3 operative-time-points before and after cardiopulmonary bypass (CPB), international normalized ratio of prothrombin time (PT-INR) and activated partial thromboplastin time (APTT) were measured in parallel using the COGC and central laboratory tests, which served as reference standards. The bias and dispersion of the two assays were calculated to assess systematic error and random error, respectively. For PT-INR, the COGC showed acceptable to good results in terms of accuracy and feasibility. However, the Bland-Altman analysis revealed that the COGC tended to overestimate APTT values, particularly after CPB. Among patients undergoing on-pump cardiovascular surgery, the COGC is a feasible and relatively accurate analyzer for assessing PT-INR but not APTT values.

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Volume-reduced washed platelets (VR-wPLTs) are useful not only for avoiding circulatory overload, but also for reducing adverse reactions. On investigating VR-wPLTs infusion by syringe, the influence of a 2-hour interruption of agitation on the in vitro properties of VR-wPLTs (44.1 ml, 2.13×10¹¹ PLTs) in M-sol in the syringe was investigated. After 2-hour storage on a bench at room temperature, the pH was maintained above 6.8, and MPV, %disc, CD62P, annexin V, %HSR, and aggregation values were not significantly changed. These results indicate that a 2-hour interruption of agitation negligibly affected the in vitro properties of VR-wPLTs in the syringe.

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