Background. Cardiopulmonary bypass (CPB) circuit will reduce the platelet count by 30-50%. As the bypass time lengthens, thrombocytopenia will progress. The objective of this study is to determine the morbidity and mortality of patients during routine and non-routine platelet transfusion in heart surgery at Philippine Heart Center.
Method. Patients admitted at the Philippine Heart Center from December 2010 to December 2012 who met our inclusion and exclusion criteria were included in this study. Subjects were grouped into those who were given platelet transfusion routinely (routine group) and those who were given platelet transfusion according to STS guidelines (non-routine group). The outcomes were noted during hospital stay: prolonged RR and SICU stay, bleeding, infection, stroke, myocardial infarction and hospital mortality.
Results. A total of 187 patients (140 in the routine group, 47 on the non-routine group) were included in the study. The demographic profile of both groups did not significantly differ. Fourteen patients had prolonged RR stay and 1 patient had prolonged SICU stay in the routine group, while; three patients had prolonged RR stay in the non-routine group. Major bleeding was noted in four patients from the group with routine platelet transfusion, with none in the non-routine group (p=0.581). Infection which includes pneumonia and would infections, were seen in both groups, 33 patients in the routine group and 6 patients in the non-routine group (p=0.148). Postoperative stroke is the same in both groups. Six patients died in the routine group and one died in the non-routine group (p=1.000). Analysis of the overall adverse outcome showed no statistical significance with a p value of 0.103.
Conclusion. The result of this study showed that a routine platelet transfusion did not statistically provide a positive clinical outcome compared to non-routine platelet transfusion. Hence, the habit of routine platelet transfusion during coronary artery bypass graft in our center should be avoided. A prospective randomized study is needed to further validate this observation.