Aspirin unresponsivness in children following cardiac surgery
Development of clots after cardiac surgery is not uncommon and is associated with complications and the risk of reintervention. Aspirin is able to block platelets, which are the blood cells responsible for initial clot formation and aspirin use leads to less thrombosis. For this reason many children will receive aspirin after cardiac surgery in order to reduce the risk of clots building up in their heart and circulation. However, despite the use of aspirin some children will still develop clots. Iniatial studies have shown that up to 1 in 4 children, as previosuly shown in adults with coronary artery diesease, may present with limited responses to a similar dose of aspirin, a phenomenon called aspirin resistance.A group of researchers from the USA has recently tested the response of cardiac children to varying doses of aspirin and found that children who do not seem to respond to aspirin (children whose's platelets are still working well despite aspirin) are at higher risk of developing clots. The researchers also observed that a lower response to aspirin was associated to a lower dose of aspirin given. It also appeared that increasing the dose of aspirin in some children was able to block the platelet function effectively. An issue which is raised by this study is whether testing platelet function should become a standard or practice to identify no- or low-responders who could benefit from higher doses of aspirin or from the use of other medications.
The full paper is available at the following link: http://www.jtcvsonline.org/article/S0022-5223(14)00761-2/abstract
