1. We tested the effect of intravenous adrenaline at 0.55–1.10 nmol min−1 kg−1 (for 3–8 min, at 7–10 min post bypass; n = 7) on both microaggregation in hirudinized whole blood, using platelet counting, and macroaggregation in platelet-rich plasma, using optical aggregometry. Control (n = 12) blood samples were taken before and at 10 and 20 min after bypass.

2. Post-bypass plasma adrenaline levels (nmol/l) increased slightly in controls (1.0 versus 0.7 at 10 min, medians; P = 0.05) and markedly with adrenaline infusion (36 versus 0.5 before infusion, P = 0.02). Microaggregation (percentage decrease in single platelets) in stirred blood, reflecting largely ADP-dependent ‘spontaneous’ aggregation, was not influenced by adrenaline infusion. In contrast, collagen (0.2 μg/ml)-induced microaggregation in blood was enhanced by adrenaline (92% versus 41%, P = 0.02), with no change in controls (60% versus 53%, P = 0.61).

3. In controls, collagen (0.6 μg/ml)-induced macroaggregation in platelet-rich plasma (extent of increase in light transmission, cm) was impaired at 10 min post bypass (5.3 versus 12.1 before bypass, P = 0.01), but was enhanced by adrenaline (7.0 versus 3.6 before infusion, P = 0.02). Platelet counts (×109/1) were decreased postbypass (155 versus 220, P = 0.02) and were not influenced by adrenaline infusion (167, P = 0.93).

4. In conclusion, following bypass and at normocalcaemia, adrenaline enhances collagen-induced aggregation in both plasma and whole blood ex vivo, independently of any change in platelet counts, but has no effect on stirring-induced ‘spontaneous’ aggregation in blood.

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