naa a22 4500 510743994 CHVBK 20180411083038.0 cr unu---uuuuu 180411e20130401xx s 000 0 eng 10.1007/s12630-012-9878-2 doi (NATIONALLICENCE)springer-10.1007/s12630-012-9878-2 The rationale for platelet transfusion during cardiopulmonary bypass: an observational study [Elektronische Daten] [Nusrat Zaffar, Ashley Joseph, C. Mazer, Rosane Nisenbaum, Keyvan Karkouti, Alan Tinmouth, Mark Peterson, Katerina Pavenski, Jeannie Callum, Christine Cserti-Gazdewich, Nadine Shehata] Justification de la transfusion de plaquettes pendant la circulation extracorporelle: une étude observationnelle Purpose: Platelet transfusion in cardiac surgery is often empiric as no established point-of-care tests are available for clear guidance of blood product administration, and there are many variables that can potentially increase the risk of bleeding during cardiopulmonary bypass. The objectives of this study were to determine the factors that influenced physicians' decisions to transfuse platelets perioperatively and to determine whether these factors coincide with characteristics using chart abstraction. Methods: This study was conducted at three university affiliated hospitals using focused physician questionnaires to assess factors influencing decisions to transfuse platelets and data abstraction to determine characteristics of patients receiving platelet transfusion during cardiac surgery. Results: Seventy-six physicians participated in the questionnaire; 41% identified bleeding and 22% identified both bleeding and the platelet count as the most significant factors influencing their decision to transfuse platelets. Of the 629 patients included in the study, 24.5% received a platelet transfusion intraoperatively and 4.5% received the transfusion postoperatively. The following factors were identified with the highest odds of receiving a platelet transfusion intraoperatively: combined bypass and valvular surgery (odds ratio [OR] 3.94; 95% confidence interval [CI] 1.94 to 8.00) and the presence of liver disease (OR 6.43; 95% CI 1.17 to 35.37). Conclusion: The use of focused physician questionnaires identified relevant aspects of patient care not apparent in the chart review that influenced the decision to transfuse platelets. The identification of bleeding, thrombocytopenia, more complex surgery, and the presence of liver disease highlights the requirement for standardized measures to assess the need for platelet transfusions in bleeding patients. Canadian Anesthesiologists' Society, 2013 Zaffar Nusrat St. Michael's Hospital, Toronto, ON, Canada aut Joseph Ashley St. Michael's Hospital, Toronto, ON, Canada aut Mazer C. Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada aut Nisenbaum Rosane Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada aut Karkouti Keyvan Department of Anesthesia, University Health Network, University of Toronto, Toronto, ON, Canada aut Tinmouth Alan University of Ottawa Centre for Transfusion Research, Ottawa Hospital Research Institute University of Ottawa, Ottawa Hospital, Ottawa, ON, Canada aut Peterson Mark Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada aut Pavenski Katerina Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada aut Callum Jeannie Department of Pathology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada aut Cserti-Gazdewich Christine Department of Pathology, University Health Network, University of Toronto, Toronto, ON, Canada aut Shehata Nadine Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada aut Canadian Journal of Anesthesia/Journal canadien d'anesthésie Springer-Verlag 60/4(2013-04-01), 345-354 0832-610X 60:4<345 2013 60 12630 https://doi.org/10.1007/s12630-012-9878-2 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s12630-012-9878-2 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Zaffar Nusrat St. Michael's Hospital, Toronto, ON, Canada aut NATIONALLICENCE 700 1- Joseph Ashley St. Michael's Hospital, Toronto, ON, Canada aut NATIONALLICENCE 700 1- Mazer C. Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada aut NATIONALLICENCE 700 1- Nisenbaum Rosane Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada aut NATIONALLICENCE 700 1- Karkouti Keyvan Department of Anesthesia, University Health Network, University of Toronto, Toronto, ON, Canada aut NATIONALLICENCE 700 1- Tinmouth Alan University of Ottawa Centre for Transfusion Research, Ottawa Hospital Research Institute University of Ottawa, Ottawa Hospital, Ottawa, ON, Canada aut NATIONALLICENCE 700 1- Peterson Mark Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada aut NATIONALLICENCE 700 1- Pavenski Katerina Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada aut NATIONALLICENCE 700 1- Callum Jeannie Department of Pathology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada aut NATIONALLICENCE 700 1- Cserti-Gazdewich Christine Department of Pathology, University Health Network, University of Toronto, Toronto, ON, Canada aut NATIONALLICENCE 700 1- Shehata Nadine Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada aut NATIONALLICENCE 773 0- Canadian Journal of Anesthesia/Journal canadien d'anesthésie Springer-Verlag 60/4(2013-04-01), 345-354 0832-610X 60:4<345 2013 60 12630 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer