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Assessment of aprotinin in the reduction of inflammatory systemic response in children undergoing surgery with
Cesar Augusto Ferreira1, Walter Villela de Andrade Vicente, Paulo Roberto Barbosa Evora
1Clinics Hospital, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil. cesarmonica@directnet.com.br
Insights
High-dose aprotinin did not reduce the inflammatory response in children undergoing extracorporeal circulation (ECC). This study found no clinical or biochemical benefits of using aprotinin for managing systemic inflammation post-ECC.
Area of Science:
- Pediatric Cardiac Surgery
- Cardiopulmonary Bypass
- Inflammatory Response
Background:
- Extracorporeal circulation (ECC) can trigger a systemic inflammatory response in pediatric patients.
- Aprotinin, a hemostatic agent, has been investigated for its potential anti-inflammatory effects during ECC.
Purpose of the Study:
- To determine if high-dose aprotinin administration reduces the inflammatory process in children following ECC.
- To assess the impact of aprotinin on clinical and biochemical markers of inflammation.
Main Methods:
- Prospective randomized study involving children aged 30 days to 4 years undergoing congenital heart disease correction with ECC.
- Two groups: Control (n=9) and Aprotinin (n=10), with aprotinin administered before and during ECC.
- Analysis of systemic inflammatory response, hemostasis, and multiorgan dysfunction using clinical and biochemical markers.
Main Results:
- Demographic and intraoperative variables were similar between groups, with greater hemodilution in the Aprotinin group.
- Aprotinin showed no significant benefit in reducing mechanical pulmonary ventilation time, postoperative ICU stay, or length of hospital stay.
- No significant reduction in clinical manifestations or serum markers of the inflammatory systemic response was observed.
Conclusions:
- Hemostatic high-dose aprotinin did not effectively minimize clinical or biochemical indicators of the inflammatory systemic response in this pediatric cohort undergoing ECC.
- The findings suggest that aprotinin is not beneficial for managing post-ECC inflammation in this patient population.
Objective:
To evaluate if the hemostatic high-dose aprotinin seems to reduce the inflammatory process after extracorporeal circulation (ECC) in children.
Methods:
A prospective randomized study was conducted on children aged 30 days to 4 years submitted to correction of acyanogenic congenital heart disease with ECC and divided into two groups: Control (n=9) and Aprotinin (n=10). In the Aprotinin Group the drug was administered before and during ECC and the systemic inflammatory response and hemostatic and multiorgan dysfunctions were analyzed on the basis of clinical and biochemical markers. Differences were considered to be significant when P<0.05.
Results:
The groups were similar regarding demographic and intraoperative variables, except for a greater hemodilution in the Aprotinin Group. The drug had no benefit regarding time of mechanical pulmonary ventilation, permanence in the postoperative ICU and length of
Conclusion:
In this series, hemostatic high-dose aprotinin did not minimize the clinical manifestations or serum markers of the inflammatory systemic response.
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