Authors
L Wang1; 1 St Georges's Hospital, UK Objective
The primary objective of this study is to determine the efficacy of Multiplate, an approved point-of-care test of platelet function, in predicting platelet dysfunction, post-CPB blood loss and blood product transfusions following coronary artery bypass graft (CABG) surgery. Method
This study enrolled two patient cohorts for analysis:
1. A ‘Pre-algorithm’ group of 360 patients – A historical dataset of patients who had CABG surgery at St George’s Hospital from 05/01/2015 to 30/12/2015, prior to the implementation of the Multiplate-based transfusion guideline.
2. A ‘Post-algorithm’ group of 366 patients ’ – A dataset from patients who underwent CABG surgery at St George’s Hospital following the implementation of the Multiplate-based platelet transfusion algorithm / guidelines, from 03/05/2016 to 29/04/2017.
We measured the association of platelet function testing with post-CPB blood loss and blood product transfusions. The primary outcome was the rate of platelet and RBC transfusions before and after the implementation of the Multiplate-based transfusion guideline. Secondary outcomes included postoperative blood loss at 12 and 24 hours, and related patients outcomes. Results
Multiplate analysis is effective and reliable at identifying underlying platelet dysfunction in patients prior to CABG surgery. Transfusion rates for all blood products (red blood cells, platelets, fresh frozen plasma and cryoprecipitate) were decreased after algorithm institution. Postoperative blood loss in 12 and 24 hours were increased in the ‘post algorithm’ group but still within the range of class 0 (i.e. insignificant postoperative bleeding). However, this did not prolong the postoperative ITU dependency and overall duration of hospital stay. Conclusion
This prospective, observational study suggests that peri-operative platelet function assessment with Multiplate was the strongest predictor for bleeding and the clinical adoption of the Multiplate test based algorithms could significantly reduce blood product transfusion requirements following CABG surgery. 
