Platelet function during cardiopulmonary bypass not changed by two different doses of aprotinin.
OBJECTIVE
Bleeding is one of the major complications of cardiopulmonary bypass (CBP) during cardiac surgery. A platelet function defect seems to be the main cause of the hemostatic problems associated with CBP. Controversial results have been reported concerning the possible protective mechanism of action of aprotinin on platelets.


METHODS
In this study we investigated the effect of two different dosages of aprotinin (high and pump-prime-only dose) on platelet reactivity in vitro and adhesion, activation and aggregation receptors on the platelet surface.


RESULTS
The results obtained from 53 patients undergoing CBP showed a significantly deficient platelet aggregation in response to agonist in all groups without differences between aprotinin treated or not treated patients. No changes in platelet surface expression of glycoprotein (GP) IIb-IIIa, GPIb, GPIV and P-selectin, were observed during CBP between patients treated with aprotinin or not.


CONCLUSIONS
These data suggest that inadequate platelet function induced by CBP is not a defect intrinsic to the platelet. We conclude that the hemostatic effect of aprotinin, regardless of the dose employed, is not mediated by protection of platelet function.
Santamaría
A
A
Department of Thrombosis and Hemostasis, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.
Mateo
J
J
Muñíz-Díaz
E
E
Oliver
A
A
Murillo
J
J
Litvan
H
H
Souto
J C
JC
Fontcuberta
J
J
D000328:Adult; D000368:Aged; D007611:Aprotinin / Q000008:administration & dosage*; D016063:Blood Loss, Surgical / Q000517:prevention & control; D001792:Blood Platelets / Q000187:drug effects*; D002315:Cardiopulmonary Bypass; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D005260:Female; D006488:Hemostasis, Surgical; D006801:Humans; D008297:Male; D008875:Middle Aged; D015539:Platelet Activation / Q000187:drug effects; D010980:Platelet Membrane Glycoproteins / Q000187:drug effects / Q000378:metabolism; D011446:Prospective Studies
D010980:Platelet Membrane Glycoproteins; D007611:Aprotinin