The role of immature platelet count and immature platelet fraction in
determining the need for transfusion in patients undergoing CABG
Abstract
Objective: Platelet dysfunction has been shown to play a role in
postoperative bleeding; however, it is not clear whether immature
platelets (IP) can induce appropriate homeostasis to prevent excessive
bleeding in patients undergoing CABG. This study investigated IP count
(IPC), IP fraction (IPF) and mean platelet volume (MPV) throughout the
hospitalization of patients undergoing CABG to elucidate their impact on
postoperative bleeding and need for transfusion. Methods: Fifty
consecutive patients undergoing elective CABG were included in this
prospective study. All CABGs were performed by the same surgical team in
a standardized fashion utilizing on-pump technique. IP and IPF were
measured preoperatively, after the completion of surgery and at
postoperative 1st,3rd, and 5th days. Whether need for transfusion was
associated with IP, IPF, MPV and platelet count was the primary outcome
measure of this study. Results: A significant increase in IPC and IPF
was observed at the postoperative first day compared to baseline values.
Preoperative IP and IPF were negatively correlated with intraoperative
blood transfusion (p=0.017, and p=0.049, respectively). Duration of the
operation, and preoperative hemoglobin and hematocrit levels were
significantly correlated with the length of hospital stay. However,
neither IP nor IPF were associated with the total amount of blood
components used throughout the hospitalization, and they were also
unassociated with the length of hospital stay. Conclusion: Although IPC
and IPF are weakly correlated with postoperative drainage and blood
transfusion frequency, they appear to have very little use –if any– in
the prediction of postoperative bleeding in patients undergoing CABG