title: Aprotinin to decrease bleeding and intraoperative blood transfusion requirements during descending thoracic and thoracoabdominal aortic aneurysmectomy using cardiopulmonary bypass.
abstract: The purpose of this retrospective study was to assess the efficacy of aprotinin, an antifibrinolytic agent, in reducing bleeding and blood transfusion requirements in patients undergoing descending thoracic or thoracoabdominal aortic aneurysmectomy using cardiopulmonary bypass (CPB). Sixty-nine consecutive patients underwent thoracic or thoracoabdominal aneurysmectomy using CPB in a 2-year period. None of the 29 patients operated on in 1990 (group 1) received aprotinin, whereas all 40 patients operated on in 1991 (group 2) were placed on a high-dose regimen of aprotinin. There were no significant differences between the two groups. Administration of aprotinin was associated with a decrease in CPB time (p = 0.02), surgical duration (p = 0.05) and intraoperative blood loss (p = 0.008) as well as a reduction in intraoperative packed red cells (p = 0.01), Cell-Saver units (p = 0.05), fresh-frozen plasma units (p = 0.002), and platelet concentrate (p = 0.01) requirements. These data suggest that aprotinin is effective in reducing bleeding and blood transfusion requirements during descending thoracic or thoracoabdominal aortic aneurysmectomy using CPB.
authors.affiliation: Department of Anesthesia, Pitié-Salpétrière University Hospital, Paris, France.
authors.forename: G
authors.initials: G
authors.lastname: Godet
authors.forename: M
authors.initials: M
authors.lastname: Bertrand
authors.forename: C M
authors.initials: CM
authors.lastname: Samama
authors.forename: E
authors.initials: E
authors.lastname: Barré
authors.forename: M H
authors.initials: MH
authors.lastname: Fléron
authors.forename: J F
authors.initials: JF
authors.lastname: Baron
authors.forename: P
authors.initials: P
authors.lastname: Coriat
authors.forename: E
authors.initials: E
authors.lastname: Kieffer
authors.forename: P
authors.initials: P
authors.lastname: Viars
mesh_terms: D000328:Adult; D000368:Aged; D017544:Aortic Aneurysm, Abdominal / Q000628:therapy*; D017545:Aortic Aneurysm, Thoracic / Q000628:therapy*; D007611:Aprotinin / Q000627:therapeutic use*; D016063:Blood Loss, Surgical / Q000517:prevention & control*; D001803:Blood Transfusion; D002315:Cardiopulmonary Bypass / Q000379:methods*; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D007430:Intraoperative Care; D008297:Male; D008875:Middle Aged; D011300:Preoperative Care; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D007611:Aprotinin