Reduction of blood transfusion requirement in open heart surgery by administration of high doses of aprotinin--preliminary results.
Reduction of homologous blood requirement in cardiac surgery is of increasing interest and may be achieved by various technical and pharmacological means. High-dose aprotinin (about 840 mg, equivalent to 6 million Kallikrein inactivator units), a serine proteinase inhibitor, was administered during open heart surgery to 60 patients refusing homologous blood transfusions or suspected to have an increased risk of bleeding. As a significant decrease in donor blood requirement could be observed, a prospective, randomised double blind study in 80 male patients undergoing primary coronary surgery with high-dose aprotinin administration was performed. Mean blood loss was reduced by 45.9% (652 ml in the treated vs 1204 ml in the untreated group, p less than 0.01) and the mean amount transfused was decreased by 74.2% (242 ml vs 937 ml, p less than 0.01). No homologous blood was needed in 57.9% of the aprotinin-treated patients and in 31.6% of patients not treated with aprotinin.
Fraedrich
G
G
Department of Cardiovascular Surgery, University Hospital, Freiburg, FRG.
Weber
C
C
Bernard
C
C
Hettwer
A
A
Schlosser
V
V
D007611:Aprotinin / Q000008:administration & dosage*; D001803:Blood Transfusion; D001810:Blood Volume / Q000187:drug effects; D002986:Clinical Trials as Topic; D001026:Coronary Artery Bypass; D003327:Coronary Disease / Q000601:surgery; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D005260:Female; D006331:Heart Diseases / Q000601:surgery*; D006349:Heart Valve Diseases / Q000601:surgery; D006350:Heart Valve Prosthesis; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012086:Reoperation
D007611:Aprotinin