Platelet reactivity in young children undergoing congenital heart disease surgery: a NITRIC randomized clinical trial substudy

• DOI: 10.1007/s44253-024-00037-2
• Publication Date: 2024-03-20T11:09:52Z
• Authors: Kim van Loon; Erik Koomen; Senna Hiensch; Nicole J. C. W. v...; Mizja Koelhuis-Faber; Jean-Luc Charlier; Jan Lammers; Oscar Imhof; Joppe Nijman; Abraham van Wijk; Johannes M. P. J....; Kristen Gibbons; Warwick Butt; Luregn J. Schlapbach; Stephen Horton; Suzanne Korporaal
• Keywords: Reactivity

Abstract Introduction The international NITRIC trial studied the hypothesis that nitric oxide (NO) applied into cardiopulmonary bypass (CPB) oxygenator in infants would improve recovery after heart surgery. In a substudy, we evaluated effect of NO CPB on (re)activity platelets measured as fibrinogen binding (platelet aggregation) and P-selectin expression degranulation) young children. Methods Platelet activity (without agonist exposure) reactivity (after stimulation by an agonist) was single center substudy trial, multicenter, randomized administration 20 parts per million (ppm) during children younger than 2 years. Blood collected at 4 time points (T1- T4); before CPB, start, weaning. Flow cytometry-based platelet presence 5 agonists tested. Differences (median fluorescence intensity (MFI)) were analyzed with mixed modelling (MEM). Results samples obtained 22 patients allocated to controls. counts dropped T1 due hemodilution blood all ( p < 0.001). Beta coefficients for allocation derived from MEM models small (standardized beta 0.07[0.03, 0.11] 0.05[0.03, 0.08]) non-significant. duration did not affect 0.09[0.02, 0.12] > 0.27) any MEMs. Conclusion ppm sweep gas undergoing Interestingly, exposure also have (re)activity. Trial registration ANZCTR, ACTRN12617000821392. Registered June 2017, https://anzctr.org.au/