The effect of aprotinin in a model of uncontrolled hemorrhagic shock.
BACKGROUND
Aprotinin has been shown to promote clot formation through its antifibrinolytic activity, by inhibiting the plasmin-induced complement activation and by protecting the platelets adhesive surface receptors. It has been successfully used in cardiac and liver transplantation surgery.


OBJECTIVE
To evaluate the effect of aprotinin in a model of uncontrolled intra-abdominal bleeding as a basis for its potential use in trauma patients.


METHODS
Twenty rats were randomly divided into 2 groups. All animals were operated on and bleeding was induced by transecting 1 lobe of the liver. In the treatment group a single dose of 30,000 U/kg of aprotinin was administered 5 minutes after the injury. The animals were monitored for hemodynamic parameters, blood loss volume, and mortality rates.


RESULTS
At 120 minutes from trauma induction a significant difference in mean blood pressure was observed: 67+/-22 mm Hg in the treatment group versus 53+/-28 mm Hg in the control group (P=.04). This difference remained consistent until the end of the experiment. Treatment with aprotinin also resulted in a tendency to an increased survival rate (P=.05) and increased mean survival time: 175+/-46 minutes as compared to 123+/-48 minutes in the controls (P=.027).


CONCLUSIONS
Early administration of aprotinin resulted in temporary hemodynamic stabilization and prolonged survival in a model of uncontrolled bleeding. Further studies are needed to establish the possible use of aprotinin in the treatment of trauma patients.
Paran
Haim
H
Department of Surgery "A," Meir Medical Center, Kfar-Sava, Israel and the Tel-Aviv University Medical School, Tel Aviv, Israel. Paran620@green.co.il
Gutman
Mordechai
M
Mayo
Ami
A
D000007:Abdominal Injuries / Q000150:complications / Q000188:drug therapy* / Q000401:mortality; D000704:Analysis of Variance; D000818:Animals; D007611:Aprotinin / Q000494:pharmacology*; D001794:Blood Pressure / Q000187:drug effects; D005260:Female; D006490:Hemostatics / Q000494:pharmacology*; D008099:Liver / Q000293:injuries; D011897:Random Allocation; D051381:Rats; D017208:Rats, Wistar; D012771:Shock, Hemorrhagic / Q000188:drug therapy* / Q000209:etiology / Q000401:mortality; D016019:Survival Analysis; D014949:Wounds, Nonpenetrating / Q000150:complications / Q000188:drug therapy* / Q000401:mortality
D006490:Hemostatics; D007611:Aprotinin