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The Journal of Thoracic and Cardiovascular Surgery, Vol 101, 968-972, Copyright © 1991 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association
M Havel, H Teufelsbauer, P Knobl, R Dalmatiner, P Jaksch, W Zwolfer, M Muller and T Vukovich
To study the hemostyptic effect of aprotinin (Trasylol) in patients
undergoing extracorporeal circulation for coronary artery bypass
operations, we randomized 12 of 24 patients to receive aprotinin in high
dosage (about 800 mg) during extracorporeal circulation. From the resulting
two groups each, one patient was excluded from the study because of
postoperative myocardial infarction (control group) and surgical hemorrhage
(aprotinin group) leading to a second operation. Although heparin was used
for anticoagulation in all 22 patients, all had a marked increase in plasma
levels of thrombin-antithrombin III complexes during extracorporeal
circulation, indicating an intravasal activation of coagulation. By
monitoring the plasma levels of fibrin degradation products in patients
without aprotinin therapy, we recorded a concomitant hyperfibrinolysis
significantly less pronounced in patients receiving aprotinin (p less than
0.005). The mean total postoperative blood loss was lower in patients
receiving aprotinin (620 ml) than in control patients (1000 ml; p less than
0.03). The results confirm previous reports of a hemostyptic effect of
aprotinin in cardiac operations. This effect is probably due to a
prevention of hyperfibrinolysis.
ARTICLES
Effect of intraoperative aprotinin administration on postoperative bleeding in patients undergoing cardiopulmonary bypass operation
Department of Surgery II, University of Vienna, Austria.
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