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High-dose aprotinin: hemostatic effects in open heart operations
F Alajmo1, G Calamai, A M Perna
1Department of Cardiothoracic Surgery, University of Florence, Italy.
The Annals of Thoracic Surgery
|October 1, 1989
Summary
High-dose aprotinin significantly reduced postoperative bleeding and the need for banked blood in open heart surgery patients. This hemostatic agent proved safe and effective, particularly for high-risk individuals.
Area of Science:
- Cardiovascular Surgery
- Anesthesiology
- Pharmacology
Background:
- Open heart operations carry risks of significant blood loss.
- Hemostatic agents are crucial for managing intraoperative and postoperative bleeding.
- Aprotinin is a serine protease inhibitor with known hemostatic properties.
Purpose of the Study:
- To evaluate the efficacy and safety of high-dose aprotinin in reducing blood loss during open heart operations.
- To assess the impact of aprotinin on the requirement for banked blood transfusions.
- To identify patient subgroups that may benefit most from aprotinin administration.
Main Methods:
- Prospective study comparing two groups of patients undergoing open heart surgery.
- Group A (n=22) received high-dose aprotinin throughout the procedure.
- Group B (n=12) served as a control group without aprotinin administration.
Main Results:
- Aprotinin group showed significantly lower postoperative bleeding (486 mL vs. 830 mL, p<0.01).
- Need for banked blood was reduced by approximately 50% in the aprotinin group (213 mL vs. 409 mL).
- No complications attributed to aprotinin were observed; hemoglobin and platelet levels remained comparable.
Conclusions:
- High-dose aprotinin is a safe and effective hemostatic agent in open heart surgery.
- Aprotinin administration leads to decreased blood loss and reduced transfusion requirements.
- Aprotinin is particularly beneficial for high-risk patients, including those undergoing reoperation or with renal failure.