Aprotinin reduces operative closure time and blood product use after pediatric bypass.
BACKGROUND
The use of aprotinin in children undergoing cardiopulmonary bypass is controversial. We hypothesized that aprotinin would reduce blood product use and operative closure time in selected pediatric patients.


METHODS
For a 6-month period starting in October 1999, consecutive cardiopulmonary bypass patients 6 months of age or less (n = 18) or having a repeat sternotomy (n = 18) received aprotinin. Similar consecutive patients from the preceding 6 months served as controls (n = 35 and 41, respectively). Data extracted from medical records included preoperative clinical characteristics, operative and postoperative procedures, and total blood product use.


RESULTS
Patients in the aprotinin and control groups were well matched with regard to preoperative and intraoperative variables. Patients 6 months of age or less who received aprotinin required less operative closure time when compared with controls (median, 93 vs 127 minutes, p = 0.004), and trended toward requiring fewer red blood cell unit exposures (median, three vs five exposures, p = 0.07). Patients undergoing repeat sternotomy who received aprotinin required less operative closure time when compared with controls (mean, 126 vs 159 minutes, p = 0.007), fewer red blood cell unit exposures (median three vs four exposures, p = 0.002), and fewer fresh-frozen plasma unit exposures (median, zero vs one exposure, p = 0.007).


CONCLUSIONS
Aprotinin reduced operative closure time and blood product exposure in pediatric patients undergoing cardiopulmonary bypass who were 6 months of age or less or underwent a repeat sternotomy.
Costello
John M
JM
Division of Cardiology and Critical Care Medicine, Children's Memorial Hospital, Chicago, Illinois, USA.
Backer
Carl L
CL
de Hoyos
Alberto
A
Binns
Helen J
HJ
Mavroudis
Constantine
C
D007611:Aprotinin / Q000494:pharmacology*; D016913:Blood Component Transfusion / Q000379:methods*; D006348:Cardiac Surgical Procedures; D002315:Cardiopulmonary Bypass; D005260:Female; D006490:Hemostatics / Q000494:pharmacology*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D012086:Reoperation; D013997:Time Factors
D006490:Hemostatics; D007611:Aprotinin