Document Detail


Aprotinin prevents cardiopulmonary bypass-induced platelet dysfunction. A scanning electron microscope study.
MedLine Citation:
PMID:  1385010     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Administration of aprotinin during extracorporeal circulation reduces blood loss and improves platelet function. METHODS AND RESULTS: To evaluate the protective effect of aprotinin on platelets, 50 patients undergoing cardiopulmonary bypass were randomized before surgery to one of three groups. Seventeen patients (group A) received continuous high-dose aprotinin (7 x 10(6) KIU) during cardiopulmonary bypass, 17 (group B) received a single bolus of aprotinin in the pump prime (2 x 10(6) KIU), and 16 (group C) received placebo. Scanning electron microscopy was used to evaluate platelet aggregation on extracellular matrix. The platelet function was graded from 1 to 4, with grade 4 being normal aggregation. Immediately after cardiopulmonary bypass, 16 patients in group A (94%) reached preoperative aggregation grade (mean grade, 3.4 +/- 0.7) compared with nine of 17 in group B (52%) (mean grade, 2.9 +/- 1.2), and none in group C (0%) (mean grade, 1.4 +/- 0.5; p < 0.001). Postoperative platelet count did not differ significantly among the three groups. After surgery, group A bled less than groups B and C (395 +/- 120 versus 488 +/- 135 and 780 +/- 408 ml, respectively; p < 0.01). Patients in the aprotinin groups received fewer red blood cell units (0.9 +/- 1.2 and 1.9 +/- 1.2 versus 3.4 +/- 1.9, respectively; p < 0.01) and were exposed to less homologous blood products (1.3 +/- 1.7 and 2.1 +/- 1.1 versus 6.1 +/- 5, respectively; p < 0.001). CONCLUSIONS: By preserving platelet function, aprotinin improves postoperative hemostasis in all patients who receive high dose and in most who receive low dose.
Authors:
R Mohr; D A Goor; A Lusky; J Lavee
Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Circulation     Volume:  86     ISSN:  0009-7322     ISO Abbreviation:  Circulation     Publication Date:  1992 Nov 
Date Detail:
Created Date:  1992-12-02     Completed Date:  1992-12-02     Revised Date:  2010-03-24    
Medline Journal Info:
Nlm Unique ID:  0147763     Medline TA:  Circulation     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  II405-9     Citation Subset:  AIM; IM    
Affiliation:
Department of Cardiac Surgery and Epidemiology, Chaim Sheba Medical Center, Tel Hashomer, Israel.
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MeSH Terms
Descriptor/Qualifier:
Aprotinin / therapeutic use*
Blood Loss, Surgical / prevention & control
Blood Platelets / drug effects*,  ultrastructure
Cardiopulmonary Bypass / adverse effects*
Coronary Artery Bypass
Female
Heart Valve Prosthesis
Humans
Male
Microscopy, Electron, Scanning
Middle Aged
Oxygenators
Platelet Aggregation / drug effects*
Platelet Count / drug effects
Chemical
Reg. No./Substance:
9087-70-1/Aprotinin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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