title: Does aprotinin influence the inflammatory response to cardiopulmonary bypass in patients?
abstract: OBJECTIVE
  Aprotinin has been shown to have anti-inflammatory properties, but its effects on the inflammatory reaction to cardiopulmonary bypass remain controversial. This prospective, randomized, double-blind study evaluated the influence of aprotinin on various blood markers of inflammation during and after cardiopulmonary bypass.
  
  
  METHODS
  Sixty male patients underwent coronary artery bypass grafting. The patients were randomized into 3 groups: a placebo group, a second group receiving 2,000,000 KIU of aprotinin followed by an infusion of 500,000 KIU/h and 2,000,000 KIU in the pump prime, and a third group receiving half this dosage. Measurements of tumor necrosis factor, interleukin 6, interleukin 8, interleukin 10, endotoxin, histamine, complement factors, prekallikrein, and prostaglandin D(2) were obtained at baseline, 30 minutes after study drug loading, 10 minutes after the beginning of cardiopulmonary bypass, before the end of bypass, 4 hours after bypass, and on the first and second postoperative days.
  
  
  RESULTS
  Aprotinin had no significant effect on any of these parameters. As expected, aprotinin reduced early blood loss in both treated groups.
  
  
  CONCLUSIONS
  These results indicate that aprotinin at doses currently used to reduce blood loss has no significant influence on the systemic inflammatory response during moderate hypothermic cardiopulmonary bypass in human subjects, as assessed by the mediators measured in this study.
authors.affiliation: Department of Anesthesiology, Erasme University Hospital, Brussels, Belgium. denis.schmartz@ulb.ac.be
authors.forename: Denis
authors.initials: D
authors.lastname: Schmartz
authors.forename: Yves
authors.initials: Y
authors.lastname: Tabardel
authors.forename: Jean-Charles
authors.initials: JC
authors.lastname: Preiser
authors.forename: Luc
authors.initials: L
authors.lastname: Barvais
authors.forename: Alain
authors.initials: A
authors.lastname: d'Hollander
authors.forename: Jean
authors.initials: J
authors.lastname: Duchateau
authors.forename: Jean-Louis
authors.initials: JL
authors.lastname: Vincent
mesh_terms: D007611:Aprotinin / Q000008:administration & dosage / Q000627:therapeutic use*; D002315:Cardiopulmonary Bypass; D004311:Double-Blind Method; D006801:Humans; D018836:Inflammation Mediators / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D015842:Serine Proteinase Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use*; D018746:Systemic Inflammatory Response Syndrome / Q000517:prevention & control*
chemical_list: D018836:Inflammation Mediators; D015842:Serine Proteinase Inhibitors; D007611:Aprotinin