Leukodepletion and aprotinin improve clinical outcome after extracorporeal circulation.
Most cardiac operations involve the use of extracorporeal circulation with its attendant systemic inflammatory response syndrome. Many anti-inflammatory strategies hold promise for reducing the associated morbidity of cardiopulmonary bypass. The application of pharmacological and mechanical strategies to control this inflammatory response now has demonstrable clinical benefit. The additional costs of these successful strategies are offset by the economic savings and improved quality of care.
Gott
J P
JP
Fuqua Heart Center, Piedmount Hospital, Atlanta, Georgia 30309, USA. gottjp@aol.com
D000305:Adrenal Cortex Hormones / Q000008:administration & dosage; D000933:Antifibrinolytic Agents / Q000008:administration & dosage / Q000191:economics / Q000494:pharmacology; D007611:Aprotinin / Q000008:administration & dosage / Q000191:economics / Q000494:pharmacology*; D002315:Cardiopulmonary Bypass / Q000009:adverse effects / Q000191:economics / Q000379:methods / Q000401:mortality; D020099:Coated Materials, Biocompatible; D003365:Costs and Cost Analysis; D005112:Extracorporeal Circulation / Q000191:economics / Q000401:mortality / Q000592:standards*; D005338:Fibrin Fibrinogen Degradation Products / Q000378:metabolism; D005374:Filtration; D006493:Heparin; D006801:Humans; D007249:Inflammation / Q000188:drug therapy / Q000209:etiology / Q000517:prevention & control; D007937:Leukapheresis; D015842:Serine Proteinase Inhibitors / Q000008:administration & dosage / Q000191:economics / Q000494:pharmacology*; D016896:Treatment Outcome
D000305:Adrenal Cortex Hormones; D000933:Antifibrinolytic Agents; D020099:Coated Materials, Biocompatible; D005338:Fibrin Fibrinogen Degradation Products; D015842:Serine Proteinase Inhibitors; C036309:fibrin fragment D; D006493:Heparin; D007611:Aprotinin