| Using activated clotting time to estimate intraoperative aprotinin concentration. | |
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MedLine Citation:
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PMID: 20093334 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: The use of aprotinin during cardiopulmonary bypass may be associated with renal dysfunction due to renal excretion of excess drug. We hypothesized that the difference between standard celite activated clotting time (ACT), which is prolonged by aprotinin, and kaolin ACT could provide an estimate of aprotinin blood level. METHODS: Fresh porcine blood was collected from six donor pigs and heparinized. Blood was stored at 4 degrees Celsius, rewarmed and aprotinin was added: 0, 100, 200, and 400 kallikrein inhibitor units/ml. Specimens were incubated at 37 degrees Celsius. Two pairs of ACT tubes (one celite and one kaolin) were measured at 37 degrees Celsius and 20 degrees Celsius using two Hemochron 401 machines. A generalized estimating equation (GEE) statistical approach was used to estimate actual aprotinin from differences in celite and kaolin ACT. RESULT: There was a significant relationship of the form y = exp(a+bx) between aprotinin concentration and the difference between celite and kaolin ACT at both 37 degrees Celsius (R(2) = 0.858) and 20 degrees Celsius (R(2) = 0.743). CONCLUSION: The time difference between celite and kaolin ACT may be a simple and inexpensive method for measuring the blood level of aprotinin during cardiopulmonary bypass. This technique may improve patient-specific dosing of aprotinin and reduce the risk of postoperative renal complications. |
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Authors:
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Yusuke Iwata; Toru Okamura; David Zurakowski; Richard A Jonas |
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Publication Detail:
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Type: Journal Article; Research Support, N.I.H., Extramural |
Journal Detail:
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Title: Perfusion Volume: 24 ISSN: 1477-111X ISO Abbreviation: Perfusion Publication Date: 2009 Nov |
Date Detail:
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Created Date: 2010-01-22 Completed Date: 2010-03-25 Revised Date: 2011-09-26 |
Medline Journal Info:
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Nlm Unique ID: 8700166 Medline TA: Perfusion Country: England |
Other Details:
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Languages: eng Pagination: 397-400 Citation Subset: IM |
Affiliation:
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Children's National Heart Institute, Children's National Medical Center, Washington, DC, USA. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Animals Aprotinin / blood* Diatomaceous Earth Humans Kaolin Partial Thromboplastin Time / methods* Swine |
| Grant Support | |
ID/Acronym/Agency:
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R01 HL060922-09/HL/NHLBI NIH HHS; R01HL060922/HL/NHLBI NIH HHS |
| Chemical | |
Reg. No./Substance:
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1332-58-7/Kaolin; 61790-53-2/Diatomaceous Earth; 9087-70-1/Aprotinin |
| Comments/Corrections | |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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