Reduced blood loss by aprotinin in thoracic surgical operations associated with high risk of bleeding. A placebo-controlled, randomized phase IV study.
OBJECTIVE
Although the blood-saving effect of aprotinin has been well documented in cardiac surgery and lung transplantation, its use in lung surgery has received less attention. We present our experience with the intraoperative application of aprotinin in lung resections with a predicted high risk of bleeding.


METHODS
Thirty-eight patients undergoing major thoracic surgical procedures were randomized into treatment and placebo groups. The treatment group (n=18) received a bolus of 2 x 10(6) kallikrein inhibitor units (KIU) of aprotinin followed by 5 x 10(5) KIU/h during surgery. The placebo group (n=20) received an isotonic saline infusion instead.


RESULTS
There was no significant difference between the groups concerning diagnosis, co-morbidity, age, sex, height, and weight. The mean intraoperative blood loss in the treatment group was significantly reduced (342 vs. 808 ml, P<0024), postoperative blood loss was also reduced (623 vs. 1282 ml, P<0.0007) and the need for blood transfusion was less (14 vs. 60, n.s.). No severe side effects of aprotinin were registered. Re-thoracotomy was necessary in two patients of the placebo group because of postoperative bleeding.


CONCLUSIONS
Aprotinin reduces the perioperative blood loss and the need for blood transfusion in thoracic surgical procedures in patients with an increased risk of bleeding.
Kyriss
T
T
Department of Thoracic Surgery, Center of Pneumology and Thoracic Surgery, Schillerhoehe Hospital, Gerlingen, Germany. kyriss@klinik-schillerhoehe.de
Wurst
H
H
Friedel
G
G
Jaki
R
R
Toomes
H
H
D007611:Aprotinin / Q000627:therapeutic use*; D016063:Blood Loss, Surgical / Q000517:prevention & control*; D001803:Blood Transfusion / Q000706:statistics & numerical data; D005260:Female; D006490:Hemostatics / Q000627:therapeutic use*; D006801:Humans; D007430:Intraoperative Care; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D013908:Thoracotomy
D006490:Hemostatics; D007611:Aprotinin