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J Thorac Cardiovasc Surg 1998;116:374
© 1998 Mosby, Inc.

Letters To The Editor

Aprotinin

Marek Ehrlich, MD

Reply to the Editor:

We thank Dr. Baciewicz for his interest in our recent article regarding our prospective study.Go 1

We were primarily interested in evaluating the efficacy and safety of low-dose aprotinin on renal function, as well as on postoperative blood loss and transfusion requirements. Because of that fact, we did not observe postoperative hypoxemia related to aprotinin, nor did any of our 50 patients have pneumonia. We did not compare arterial oxygen tensions, levels of positive end-expiratory pressure, inspired oxygen fractions, and chest x-ray films in our study. However, Goldstein and colleaguesGo 2 reported one death owing to fulminant pneumonia in a patient who received the conventional Hammersmith (full dose) aprotinin regimen. It remains unclear in the study performed by the Columbia group whether this complication was drug-related.

Nevertheless, the possibility of an adverse respiratory reaction with the use of aprotinin should be addressed in future studies.

Department of Cardio-Thoracic SurgeryMount Sinai Medical Center, One Gustave Levy Place, Box 1028, New York City, NY 1002912/8/90665

References

  1. Ehrlich M, Grabenwöger M, Cartes-Zumelzu F, Luckner D, Kovarik J, Laufer G, et al. Operations on the thoracic aorta and hypothermic circulatory arrest: Is aprotinin safe? J Thorac Cardiovasc Surg 1998;115:220-5.[Abstract/Free Full Text]
  2. Goldstein DJ, DeRosa CM, Mongero LB, Weinberg AD, Michler RE, Rose EA, et al. Safety and efficacy of aprotinin under conditions of deep hypothermia and circulatory arrest. J Thorac Cardiovasc Surg 1995;110:1615-22.[Abstract/Free Full Text]




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