Summary
We studied the effect of coronary-artery bypass surgery on blood cells and platelets. Hematological parameters of eighty-three patients were measured by an automated cell counting and sizing analyzer. Sampling time was from 24 h prior to 10 days after surgery. During this time leukocytes and platelets showed characteristic changes in numbers and size, whereas red blood cells revealed no typical modifications. Even though it seems clear that changes of hematological parameters occur after bypass surgery, it is important to be aware of the actual extent of such changes. Therefore the data of 50 patients who had had no post-operative clinical complications were combined to generate diagrams of those parameters that had changed in a characteristic fashion. The diagrams showing average changes, and 99% confidence intervals in mean platelet volume and platelet count were able to identify seven (out of 7) cases with complications up to 48 h before clinical signs were apparent. Complications ranged from mild (3 cases with infections) to severe (4 cases with thrombosis, embolic thrombosis and/or reinfarction). Diagrams showing changes in leukocyte parameters were able to identify only two cases with infections. Even though the number of cases is yet small, the results suggest that surveillance of platelet parameters may be useful in postoperative care. Furthermore, this study was able to confirm the recent findings of Trowbridge and Martin [18] that an abnormal increase in platelet volume distribution width and low platelet counts found in patients with coronary heart disease may serve as good indicators for the prethrombotic state and the risk of myocardial infarction.
Similar content being viewed by others
Abbreviations
- MPV:
-
mean platelet volume
- PDW:
-
platelet volume distribution width
- RDW:
-
red blood cell distribution width
- WBC:
-
white blood cells
- RBC:
-
red blood cells
References
Abraham KP, Tunney PJ, Corliss JW, Ulirsch RC, Schumacher HR (1989) Effects of cardiac and noncardiac surgery on peripheral blood cell counts and morphology. Lab Med 20:311–314
Bailey PE, Antonas KN (1982) Variation in platelet size during recovery from thrombocytopenia following extracorporeal circulation. Clin Lab Haematol 4:359–364
Boonstra PW, Vermenlen FEE, Leusink JA (1986) Hematological advantages of a membrane oxygenator over a bubble oxygenator in long perfusions. Ann Thorac Surg 41:297–300
Cameron HA, Philips R, Ibbotson RM, Carson PHM (1983) Platelet size in myocardial infarction. Br Med J 287:449–451
Claman HN (1972) Corticosteroids and lymphoid cells. N Engl J Med 287:388–397
van den Dungen JJAM, Karliczek GF, Brenken U (1982) Clinical study of blood trauma during perfusion with membrane and bubble oxygenator. J Thorac Cardiovasc Surg 83:108–116
Erne P, Wardle J, Sanders K, Lewis SM, Maseri A (1988) Mean platelet volume and size distribution and their sensitivity to agonists in patients with coronary artery disease and congestive heart failure. Thrombo Haemostas 59:259–263
Fosse E, Opdahl H, Svennevig JL (1985) White blood cell populations in persons undergoing major vascular surgery. Scand J Thorac Cardiovasc Surg 19:247–252
Harker LA, Malpass TW, Branson HE, Hessel EA, Slichter SJ (1980) Mechanism of abnormal bleeding in patients undergoing cardiopulmonary bypass: Acquired transient platelet dysfunction associated with selective alpha-granule release. Blood 56:824–834
Harker LA, Ritchie JL (1980) The role of platelets in acute vascular events. Circulation 62 (Suppl V):13–18
Jacob HS, Craddock PR, Hammerschmidt DE, Moldow CF (1980) Complement-induced granulocyte aggregation. N Engl J Med 302:789–794
Laufer N, Merin G, Grover NB, Pessachowicz B, Borman JB (1975) The influence of cardiopulmonary bypass on the size of human platelets. J Thorac Cardiovasc Surg 70:727–731
Martin JF, Daniel TD, Trowbridge EA (1987) Acute and chronic changes in platelet volume and count after cardiopulmonary bypass induced thrombocytopenia in man. Thrombo Haemostas 57:55–58
Odell TT Jr, Murphy JR, Jackson CW (1976) Stimulation of megakaryocytopoiesis by acute thrombocytopenia in rats. Blood 48:765–775
Pike OM, Marquiss JE, Weiner RS, Breckenridge RT (1972) A study of platelet counts during cardiopulmonary bypass. Transfusion 12:119–22
Ryhanen P, Herva E, Hollmen A (1979) Changes in peripheral blood leukocyte counts, lymphocyte populations, and in vitro transformation after heart valve replacement. J Thorac Cardiovasc Surg 77:259–266
Thompson C, Eaton KA, Princiotta SM, Tushin CA, Valeri CR (1982) Size dependent platelet subpopulations: Relationship of platelet volume to ultrastructure, enzymatic activity and function. Brit J Haematol 50:509–519
Trwobridge EA, Martin JF (1987) The platelet volume distribution: a signature of the prethrombotic state in coronary heart disease? Thromb Haemostas 58:714–717
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
von Ruecker, A., Hufnagel, P., Dickerhoff, R. et al. Qualitative and quantitative changes in platelets after coronary-artery bypass surgery may help identify thrombotic complications and infections. Klin Wochenschr 67, 1042–1047 (1989). https://doi.org/10.1007/BF01727006
Received:
Revised:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF01727006