Efficacy of aprotinin with various anticoagulant agents in cardiopulmonary bypass.
BACKGROUND
Aprotinin has recently been approved for clinical use in cardiopulmonary bypass. Although unfractionated heparin has been the only anticoagulant widely used for cardiopulmonary bypass, disadvantages involving heparin have led to ongoing investigations of alternative anticoagulant agents.


METHODS
The objective of this study was to evaluate the efficacy of aprotinin in combination with other anticoagulant agents, specifically low molecular weight heparin and recombinant hirudin, using a dog model of cardiopulmonary bypass.


RESULTS
The blood conservation resulting from the use of aprotinin was observed only with unfractionated heparin. Efficacy of anticoagulation as measured by protein deposits in the bypass circuit filter revealed an unexpected reduction in the quantity of deposits when aprotinin was used in combination with low molecular weight heparin.


CONCLUSIONS
As alternative anticoagulant agents are sought, the potential benefits of aprotinin in the reduction of operative blood loss must be evaluated independently for each anticoagulant agent.
Terrell
M R
MR
Department of Thoracic and Cardiovascular Surgery, Loyola University Medical Center, Maywood, Illinois 60153, USA.
Walenga
J M
JM
Koza
M J
MJ
Pifarré
R
R
D000818:Animals; D000925:Anticoagulants / Q000008:administration & dosage / Q000627:therapeutic use*; D000991:Antithrombins / Q000008:administration & dosage / Q000627:therapeutic use; D007611:Aprotinin / Q000008:administration & dosage / Q000627:therapeutic use*; D001777:Blood Coagulation / Q000187:drug effects; D016063:Blood Loss, Surgical / Q000517:prevention & control; D002315:Cardiopulmonary Bypass / Q000295:instrumentation; D004195:Disease Models, Animal; D004285:Dogs; D004338:Drug Combinations; D005374:Filtration / Q000295:instrumentation; D006490:Hemostatics / Q000008:administration & dosage / Q000627:therapeutic use*; D006493:Heparin / Q000008:administration & dosage / Q000627:therapeutic use; D006495:Heparin, Low-Molecular-Weight / Q000008:administration & dosage / Q000627:therapeutic use; D024764:Hirudin Therapy; D006629:Hirudins / Q000008:administration & dosage; D008297:Male; D010314:Partial Thromboplastin Time; D011994:Recombinant Proteins
D000925:Anticoagulants; D000991:Antithrombins; D004338:Drug Combinations; D006490:Hemostatics; D006495:Heparin, Low-Molecular-Weight; D006629:Hirudins; D011994:Recombinant Proteins; D006493:Heparin; D007611:Aprotinin