Randomized blinded study of aprotinin infusion for liver crush injuries in the pig model

Repeat exploratory laparotomies for intra-abdominal bleeding in patients who sustain severe blunt intra-abdominal trauma are common. Reexploration usually reveals no single site of bleeding and the abdomen is closed with laparotomy pad packing, with a presumed diagnosis of coagulopathy. These postoperative coagulational defects may be the result of dilution, consumption, dysfunction, or acquired defects of either the coagulation, fibrinolytic, or platelet systems. The liver plays a major role in the balance of hemostatic systems, and this balance is disrupted by liver trauma. This study investigates the use of intravenous aprotinin, a naturally occurring serine protease inhibitor, in a pig liver crush model to evaluate its effectiveness in reducing intra-abdominal bleeding in experimentally induced shock and non-shock states.