CARDIOVASCULAR ENGINEERING Journal for Extracorporeal Circulation, Assist Devices,Transplantation and Artificial Organs
	Volume 2, 1997, No 3

Experiences with Very Low Dose Aprotinin Application in Cardiac Surgery

J. Ptrie, P. Bourel, O. Saint-Maurice, T. Folliguet, F. Laborde

Abstract:
Today, many teams are using Aprotinin in cardiac surgery. However, its dosage is much debated. The purpose of this study was to define whether a very low dose of Aprotinin (250 000 UIK) would be effective in reducing postoperative blood loss as well as the amount of red cell transfusion. This is a retrospective study comparing all patients operated on during the last four months of 1993 and 1994. In 1993, no antifibrinolytic agent was given to patients (Group 1); while in 1994 each patient benefited from 250 000 UIK of Aprotinin after cardiopulmonary bypass (Group 2). So as to match both groups, we only compared patients with coronary artery bypass grafts. There were 56 patients in Group 1 and 72 in Group 2. During this period, the same surgical team operated all patients and the technique of cardiopulmonary bypass was identical. Numerous variables were studied. However, the only statistically significant differences were as follows : - Amount of protamine used (294 +/-52 Gp 1 Vs. 261 +/-48 mg Gp 2) p <0.01 postoperative bleeding (1150 +/-627 gp 1 vs. 882 +/-453 ml gp 2) p < 0.01 number of patients transfused with homologous blood (57% gp 1 vs. 36% gp 2) p < 0.05 amount of red pack cell units transfused during hospitalization (2.7 +/- 3.3 gp 1 vs. 1.3 +/- 1 gp 2) p < 0.01 this study allowed us to conclude that very low dose aprotinin reduces red cell transfusions as well as postoperative blood loss after coronary bypass grafts. this technique combined with other blood saving means should enable the reduction of the number of patients transfused with homologous blood after this type of surgery.

Keywords:
Myocardial revascularization, very low dose Aprotinin, red pack cells transfusion, postoperative bleeding

Address for Correspondence:

Reference:
(CVE. 1997; 2 (3): 159-164)

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