Platelet function, coagulation tests, and cardiopulmonary bypass: lack of correlation between pre-operative and intra-operative whole blood lumiaggregometry and peri-operative blood loss in patients receiving autologous platelet-rich plasma.

Platelet function and blood coagulation were studied and correlated with the post-operative red blood cell (RBC) loss in 41 patients that underwent cardiopulmonary bypass surgery. Before and after surgery, whole blood platelet aggregation and secretion were tested with different agonists, and the platelet count, prothrombin time, and activated partial thromboplastin time measured simultaneously. Post-operatively, RBC loss in chest fluid was also calculated. Platelet aggregation and secretion with different agonists (except with ristocetin and adenosine diphosphate (ADP)) were decreased significantly after protamine and platelet-rich plasma administration. There were no significant differences in aggregation and secretion immediately after cardiopulmonary bypass compared with after platelet-rich plasma administration With ADP, adenosine triphosphate (ATP) release was decreased significantly after the platelet-rich plasma infusion compared with post-protamine. Platelet count decreased significantly during surgery and remained low after platelet-rich plasma infusion. The clotting times were increased significantly after surgery, and after platelet-rich plasma infusion, the prothrombin time decreased significantly relative to the post-protamine value, the activated partial thromboplastin time being essentially unchanged. Postoperatively, the total volume of RBC collected after 36 h was 158 +/- 13 ml and there was no significant correlation with the above parameters. We conclude that pre-operative or intra-operative whole blood lumi-aggregometry is not a predictor of post-operative blood loss in patients receiving platelet-rich plasma intra-operatively.

Histological study of the effects of three anti-inflammatory preparations on the gastric mucosa.

Patients with osteoarthritis were entered into a single-blind trial comparing the effects on the gastric mucosa of a four week course of indomethacin, sulindac and a compound of paracetamol and dextropropoxyphene (Distalgesic). The presence and severity of both acute and chronic gastritis were assessed by histological examination of endoscopic biopsy specimens taken from five standard sites in th stomach of each patient before and at the end of the four week period. The presence and severity of chronic gastritis was not affected by the treatment in any of the groups. The pattern of acute gastritis was complex, many of the patients having acute inflammatory changes in their initial biopsy specimens. At least one patient in each treatment group developed marked acute gastritis during the treatment period, but a significant overall increase in the severity of these changes was only found in the group treated with sulindac.