Rossi Michele, Lewis Michael, Hutchinson Nevil
Department of Cardiac Surgery, Royal Sussex University Hospital, Brighton BN2 5BE, United Kingdom.
Tex Heart Inst J. 2010;37(3):361-4.
Patients with idiopathic thrombocytopenic purpura have safely undergone cardiac surgical procedures; however, platelets were transfused in 20 of 24 reported instances, and no point-of-care testing of coagulation status was performed. Herein, we report the case of a patient with idiopathic thrombocytopenic purpura who required urgent coronary artery bypass grafting and intra-aortic balloon pump support. Rotational thromboelastometry was used as a point-of-care test of the patient's coagulation status. No preoperative prophylactic transfusion of allogeneic platelets was necessary, and in fact the patient required no allogeneic blood products during his hospitalization. We believe that point-of-care coagulation tests such as thromboelastometry warrant further evaluation regarding their usefulness in the clinical decision of whether to transfuse platelets and other blood products.
特发性血小板减少性紫癜患者已安全接受心脏外科手术；然而，在24例报告病例中有20例输注了血小板，且未进行凝血状态的即时检测。在此，我们报告一例特发性血小板减少性紫癜患者，该患者需要紧急冠状动脉旁路移植术和主动脉内球囊泵支持。采用旋转血栓弹力图作为患者凝血状态的即时检测。术前无需预防性输注异体血小板，事实上患者在住院期间未需要任何异体血液制品。我们认为，诸如血栓弹力图之类的即时凝血检测在决定是否输注血小板和其他血液制品的临床决策中的有用性值得进一步评估。
