{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T00:57:08Z","timestamp":1760057828591,"version":"build-2065373602"},"reference-count":28,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2025,2,28]],"date-time":"2025-02-28T00:00:00Z","timestamp":1740700800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Objectives: This study sought to determine the platelet function and viscoelastic blood properties in the pre- and postoperative period using three different point-of-care (POC) devices (Multiplate\u00ae, Siemens PFA-200\u00ae and ROTEM\u00ae). We aimed to investigate the association between preoperative POC test results and bleeding outcomes. Postoperative changes in blood hemostatic properties were also evaluated, as well as the agreement between two platelet function analyzers and rotational thromboelastometry parameters. Methods: The study was conducted in a prospective observational fashion. Patients undergoing elective coronary artery bypass graft surgery (CABG) were enrolled. Hemostatic blood properties were assessed using three different POC devices; two platelet function analyzers were used: (1) Impedance aggregometry (Multiplate\u00ae) with the arachidonic acid (ASPI) test and adenosine diphosphate (ADP) test. (2) The Siemens INNOVANCE\u00ae PFA-200 System with the following assays: the PFA Collagen\/EPI test, PFA Collagen\/ADP test, and the INNOVANCE\u00ae PFA P2Y test. Viscoelastic blood properties were assessed using ROTEM\u00ae delta (TEM Innovations GmbH, Munich, Germany). POC tests were performed simultaneously at two different time points: (1) before surgery and (2) on postoperative day 4, respectively. The primary outcome was defined as amounts of perioperative bleeding and transfusion requirements, classified according to the universal definition for perioperative bleeding (UDPB) score. Results: The study recruited a total number of 63 patients undergoing elective isolated coronary artery bypass graft surgery (CABG). Based on the packed red blood cell (PRBC) transfusion requirements, patients with excessive bleeding were not just only frequently transfused (87.5% vs. 48.9%, p = 0.007) but were also transfused with higher amounts of PRBCs (1338.75 mL \u00b1 SD 1416.49 vs. 289.36 mL \u00b1 373.07, p &lt; 0.001). The FIBTEM A30 results significantly correlated with excessive bleeding (Correlation Coefficient Rho = \u22120.280, p = 0.028). Regression analysis revealed FIBTEM A 30 as a strongest predictor of 24 h chest tube output (CTO) (R Square 0.108, p = 0.009). The receiver operating characteristics curve (ROC) analysis showed that a preoperative FIBTEM A30 &lt; 10.86 mm predicted excessive bleeding with 94% sensitivity and 50% specificity (ROC AUC 68.4%). The multiplate ASPI test results were significantly higher (35.24 AUC \u00b1 SD 22.24 vs. 19.43 AUC \u00b1 SD 10.74) and the proportion of Aspirin responders was significantly lower (42.4% vs. 76.7%, p = 0.006) in patients considered to have insignificant bleeding. On postoperative day 4, we found platelet hyperreactivity in the ASPItest coupled with a ROTEM-documented shift towards hypercoagulability. Conclusions: Modern hemostatic management and perioperative antiplatelet therapy (APT) administration\/discontinuation management should be guided by thromboelastometry and platelet function testing. Prospective interventional trials are necessary to validate such an approach in multicentric studies.<\/jats:p>","DOI":"10.3390\/jcm14051640","type":"journal-article","created":{"date-parts":[[2025,2,28]],"date-time":"2025-02-28T02:48:37Z","timestamp":1740710917000},"page":"1640","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Perioperative Changes in Hemostatic Properties as Assessed by Multiplate, Siemens PFA-200, and ROTEM\u2014A Comparative Study"],"prefix":"10.3390","volume":"14","author":[{"given":"Zrinka","family":"Starcevic","sequence":"first","affiliation":[{"name":"Department of Cardiac Surgery, University Hospital Centre Zagreb, 10000 Zagreb, Croatia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martina","family":"Zrno-Mihaljevic","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, University Hospital Centre Zagreb, 10000 Zagreb, Croatia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hrvoje","family":"Gasparovic","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, University Hospital Centre Zagreb, 10000 Zagreb, Croatia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marijan","family":"Pasalic","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Diseases, University Hospital Centre Zagreb, 10000 Zagreb, Croatia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mirna","family":"Petricevic","sequence":"additional","affiliation":[{"name":"Department of Health Studies, University of Split, 21000 Split, Croatia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7315-9528","authenticated-orcid":false,"given":"Klaus","family":"Goerlinger","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Intensive Care Medicine, University Hospital Essen, University Duisburg-Essen, 45127 Essen, Germany"},{"name":"Medical Department, Tem Innovations, 81829 Munich, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mate","family":"Petricevic","sequence":"additional","affiliation":[{"name":"Department of Health Studies, University of Split, 21000 Split, Croatia"},{"name":"School of Medicine, University Hospital of Split, University of Split, 21000 Split, Croatia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,2,28]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1873","DOI":"10.1007\/s00134-004-2388-0","article-title":"Coagulation disorders of cardiopulmonary bypass: A review","volume":"30","author":"Paparella","year":"2004","journal-title":"Intensiv. 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