Sage Journals: Discover world-class research

Abstract

A study was undertaken to compare the two doses of aprotinin and the amount of autologous blood transfused in order to determine the optimal dose of this inhibitor for use in cardiac surgery. A total of 120 patients undergoing elective cardiac surgery from November 1990 to April 1992 took part in this randomized double-blind study. Two groups of 60 patients were treated. Patients in the high-dose group were given the dose of aprotinin recommended by the Hammersmith group (6 million kallikrein inactivator units), the other 60 (the low-dose group) received half the dose. Blood loss from thoracic drains in the postoperative period showed a statistically significant difference between the two groups between 6 and 12 h (a mean loss of 610.9 ml in the low dose). The blood and clotting markers did not differentiate between the high- and low-dose patients. In combination with autologous blood transfusions, a low dose of aprotinin appears as efficient in reducing postoperative blood loss as the high-dose Regimen.

Keywords

cardiovascular surgery postoperative blood loss aprotinin efficacy. autologous blood transfusions. fluid replacement

Get full access to this article

View all access options for this article.

References

Fraedrich

, Weber

, Bernard

. Reduction of blood transfusion requirement in open heart surgery by administration of high doses of aprotinin - preliminary result. Thorac Cardiovasc Surg 1989; 37: 89–91

Wildevuur

CRH

, Eijsman

, Roozendaal

. Platelet preservation during cardiopulmonary bypass with aprotinin 1989; 3: 533–8.

Royston

, Bidstrup

, Taylor

. Effect of aprotinin on the need for blood transfusion after repeat onen hrart surgury. Lancet 1987; 2: 1289–91.

Gschoßmann

. Aprotinin in cardiovascular surgery (thesis) Munich: Ludwig-Maximilians-Universität, 1994.

Czer

, Bateman

, Gray

. Treatment of severe platelet dysfunction and hemorrhage after cardiopulmonary bypass: Reduction in blood product usage with desmopressin. J Am Coll Cardiol 1987; 9: 1139–47.

Salzman

, Weinstein

, Weintraub

. Treatment with desmopressin acetate to reduce blood loss after cardiac surgery. N Engl J Med 1986; 314: 1402–6.

Teoh

, Christakis

, Weisel

. Blood conservation with membrane oxygenators and dipyridamole. Ann Thorac Surg 1987; 44: 40–7.

Addonizio

, Fisher

, Jenkin

. Iloprost (ZK 36374), a stable analogue of prostacyclin preserves platelets during stimulated extracorporeal circulation. J Thorac Cardiovasc Surg 1985; 89: 926–33.

Fish

, Sarnquist

, van Steenis

. A prospective, randomised study of the effects of prostacyclin on platelets and blood loss during coronary bypass operations. J Thorac Cardiovasc Surg 1986; 91: 436–42.

10.

Fritz

, Wunderer

. Biochemistry and applications of aprotinin, the kallikrein inhibitor from bovine organs. Arzneimittel Forschung 1983; 33: 479–94.

11.

Verstraete

. Clinical applications of inhibitors of fibrinolysis. Drugs 1985; 29: 236–61.

12.

Aoki

, Naito

, Yoshida

. Inhibition of platelet aggregation by protease inhibitors. Possible involvement of proteases in platelet aggregation. Blood 1978; 52: 1–12.

13.

Bidstrup

, Royston

, Sapsford

. Reduction in blood loss and blood use after cardiopulmonary bypass with high-dose aprotinin (Trasylol). J Thorac Cardiovasc Surg 1989; 97: 364–72.

14.

Dietrich

, Henze

, Barankay

. High-dose aprotinin application reduces homologous blood requirement in cardiac surgery. J Cardiothorac Anesth 1989; 3: 79.

Efficacy of Aprotinin in Different Doses and Autologous Blood Transfusions in Cardiac Surgery

Abstract

Keywords

Get full access to this article

References