Platelet function in paediatric cardiac patients on bypass and ECMO
Research type
Research Study
Full title
Platelet function in paediatric cardiac patients on cardiopulmonary bypass and extra-corporeal life support
IRAS ID
165194
Contact name
S Watson
Contact email
Sponsor organisation
University of Birmingham
Duration of Study in the UK
4 years, 8 months, 5 days
Research summary
Congenital cardiac diseases are common, affecting 8/1000 live births in the UK, with almost 6,000 cardiac surgical procedures performed per year.
As well as cardiopulmonary bypass being required in order to be able to perform the majority of cardiac surgical procedures, an increasing number of children are supported with longer term bypass circuits (Extra-Corporeal Life Support, ECLS), or ventricular assist devices (VADs) either as a bridge to transplantation or to give time to allow heart function to recover from failing states from varying causes.
All forms of cardiac support, either bypass circuits, ECLS circuits or VADs are associated with significant haemostatic disturbances.
In some patients there appears to be a phenomenon where they develop haemorrhagic and thrombotic complications (bleeding and clotting) at the same time. Studies have shown that around 40% of patients have evidence of thrombosis and haemorrhage, and for these patients the mortality rate is over 70%.
Platelet function research in paediatric cardiac patients has only taken place in small numbers of observational studies. The results have shown a decrease in absolute platelet numbers immediately following cessation of cardiopulmonary bypass, with qualitative measures of function showing conflicting results depending on length of bypass, and age of the patient. None of the existing studies have elucidated why the platelet function is altered in these patients.
My hypothesis is that platelet activation occurs during by-pass because of loss of normal inhibitory mechanisms from the blood vessel wall. In the group of patients where clotting and bleeding co-exist there could also be desensitisation of platelet receptors.
This study would be a prospective observational study of the number and function of platelets in paediatric patients undergoing cardiopulmonary bypass, and longer term support. We would use small volume functional assays to look at platelet function with each patient acting as their own control.REC name
South Central - Berkshire Research Ethics Committee
REC reference
15/SC/0038
Date of REC Opinion
15 Jan 2015
REC opinion
Favourable Opinion