[Effects of "low dose" aprotinin in open heart surgery and its plasma concentration].
To determine the effects of "low dose" aprotinin in open heart surgery, we administrated it in 109 cases of CABG or prosthetic valve replacement. Patients in Group A (Aprotinin) received continuous infusion of aprotinin at the rate of 6*10(5) KIU/hr from the induction of anesthesia to the start of ECC (extra corporeal circulation), and from the end of ECC to the end of blood stanching. They also received additional 5*10(5) KIU aprotinin in ECC prime volumes. 50 patients in Group C (Control) received neither aprotinin nor placebo. Bleeding after ECC (Group A: 315.7 +/- 203.1 ml, Group C: 484.3 +/- 598.5 ml p < 0.01), the first 6 hours drainage (Group A: 273.0 +/- 210.0 ml, Group C: 404.7 +/- 243.2 ml p < 0.01), the first 24 hours drainage (Group A: 510.2 +/- 248.0 ml, Group C: 721 +/- 317.7 ml p < 0.01) was significantly reduced in Group A. Amounts of homologous blood transfusion were significantly reduced in group A. (Group A: 4.7 +/- 5.3 units, Group C: 8.5 +/- 6.4 units p < 0.01). Among the patients with autologous blood transfusion, the rate of the patients without homologous transfusion was significantly higher in Group A (group A: 40/66 cases, Group C: 8/33 cases p < 0.01). The ECC time and the operation time was significantly shorter in Group A. There were 69 patients (Group A: 40, Group C: 29) whose ECC time was longer than 120 minutes.(ABSTRACT TRUNCATED AT 250 WORDS)
Nakamura
T
T
Department of Cardiovascular Surgery, Shizuoka City Hospital, Japan.
Shimamoto
M
M
Yamazaki
F
F
Fujita
S
S
Yoshimura
T
T
Ueno
T
T
Oyanagi
H
H
Shinozaki
T
T
D000368:Aged; D007611:Aprotinin / Q000008:administration & dosage* / Q000097:blood; D016063:Blood Loss, Surgical / Q000517:prevention & control*; D001803:Blood Transfusion; D001026:Coronary Artery Bypass; D005112:Extracorporeal Circulation; D005260:Female; D006331:Heart Diseases / Q000601:surgery*; D006350:Heart Valve Prosthesis; D006801:Humans; D008297:Male; D008875:Middle Aged
D007611:Aprotinin