HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Sertaç Çiçek Ufuk Demirkiliç Harun Tatar Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Çiçek, S. Articles by Tatar, H. Search for Related Content PubMed PubMed Citation Articles by Çiçek, S. Articles by Tatar, H.

Ann Thorac Surg 1996;61:1372-1376
© 1996 The Society of Thoracic Surgeons

---

Original Articles: Cardiovascular

Postoperative Aprotinin: Effect on Blood Loss and Transfusion Requirements in Cardiac Operations

Department of Cardiovascular Surgery, GATA Gülhane School of Medicine, Ankara, Turkey

Accepted for publication January 10, 1996.

Background. Aprotinin has been used increasingly to reduce postoperative blood loss in open heart operations. Although it was reported as safe in earlier studies, the overall safety of prophylactic use has been questioned recently. Because of the potential for complications and the high cost, it will be reasonable to use aprotinin more selectively in the postoperative period.

Methods. We prospectively studied the effect of postoperative low-dose aprotinin (2 million kallikrein inactivator units [280 mg]) on blood loss and transfusion requirements in patients undergoing cardiopulmonary bypass. Seventy-five patients were randomly assigned to three groups: prophylactic high-dose aprotinin (group 1), postoperative aprotinin (group 2), or a nonmedicated control group (group 3).

Results. The three groups were comparable in all demographic and operative variables. Postoperative chest tube drainage was significantly decreased in both aprotinin groups compared with that in the control group (295 mL in group 1 and 325 mL in group 2 versus 411 mL in group 3; p< 0.05). No significant difference was seen between the two aprotinin groups. The use of homologous blood products was significantly less in group 1 and group 2 than in group 3 (1.15 ± 1.13 U and 1.35 ± 1.30 U versus 2.55 ± 1.09 U; p < 0.05).

Conclusions. Our results suggest that postoperative aprotinin reduces blood loss and transfusion requirements comparably with prophylactic high-dose aprotinin. Thus, one can restrict its use to patients with excessive postoperative bleeding.

This article has been cited by other articles:

				J. R. Brown, N. J.O. Birkmeyer, and G. T. O'Connor Meta-Analysis Comparing the Effectiveness and Adverse Outcomes of Antifibrinolytic Agents in Cardiac Surgery Circulation, June 5, 2007; 115(22): 2801 - 2813. [Abstract] [Full Text] [PDF]

				D. Fergusson, K. C. Glass, B. Hutton, and S. Shapiro Randomized controlled trials of aprotinin in cardiac surgery: could clinical equipoise have stopped the bleeding? Clinical Trials, June 1, 2005; 2(3): 218 - 232. [Abstract] [PDF]

				J. M. Alvarez, L. R. Jackson, C. Chatwin, and J. J. Smolich Low-dose postoperative aprotinin reduces mediastinal drainage and blood product use in patients undergoing primary coronary artery bypass grafting who are taking aspirin: A prospective, randomized, double-blind, placebo-controlled trial J. Thorac. Cardiovasc. Surg., September 1, 2001; 122(3): 457 - 463. [Abstract] [Full Text] [PDF]

				M. J. Ray, M. M. Hales, L. Brown, M. F. O'Brien, and E. G. Stafford Postoperatively administered aprotinin or epsilon aminocaproic acid after cardiopulmonary bypass has limited benefit Ann. Thorac. Surg., August 1, 2001; 72(2): 521 - 526. [Abstract] [Full Text] [PDF]

				F. Forestier, S. Belisle, D. Robitaille, R. Martineau, L. P. Perrault, and J.-F. Hardy Low-dose aprotinin is ineffective to treat excessive bleeding after cardiopulmonary bypass Ann. Thorac. Surg., February 1, 2000; 69(2): 452 - 456. [Abstract] [Full Text] [PDF]