Dose dependent effect of aprotinin on rate of clot formation.
Forty-eight patients scheduled for elective cardiac surgery were randomly assigned to receive aprotinin in the following doses: 0.2 mg kg-1 (group A), 0.7 mg kg-1 (group B), 1 mg kg-1 (group C) and 1.4 mg kg-1 (group D). Clot formation was analysed by thromboelastography immediately after induction of anaesthesia and again 30 min after administration of aprotinin. Rate of clot formation was assessed using R (reaction time = rate of initial fibrin formation), K (clot formation time = rate of fibrin build-up and cross linking) and angle of clot formation (denoting speed at which solid clot forms). Strength of the clot was assessed by maximal amplitude of clot formation (MA) and % lysis after 30 and 60 min. Significant reduction of R and K times and increase in angle of clot formation was observed in groups A and B. This effect was not apparent in the other groups. In group D, an increase in R time was noted. These findings indicate a dose-dependent effect of aprotinin on rate of clot formation with an earlier clot formation at low doses.
De Hert
S G
SG
Department of Anaesthesiology, University of Antwerp, Belgium.
Farooqi
N U
NU
Delrue
G L
GL
Broecke
P W
PW
Vermeyen
K M
KM
Adriaensen
H F
HF
D000368:Aged; D007611:Aprotinin / Q000494:pharmacology*; D001777:Blood Coagulation / Q000187:drug effects*; D006348:Cardiac Surgical Procedures; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D005260:Female; D006490:Hemostatics / Q000494:pharmacology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015842:Serine Proteinase Inhibitors / Q000494:pharmacology*; D013916:Thrombelastography
D006490:Hemostatics; D015842:Serine Proteinase Inhibitors; D007611:Aprotinin