Protective effect of aprotinin against lung damage in patients undergoing CABG surgery.
OBJECTIVE
We investigated the protective effects of aprotinin, administered in the pulmonary artery, on lung damage after cardiopulmonary bypass (CPB).


METHODS
A total of 20 patients undergoing elective coronary artery bypass grafting operations was included in the study and divided into two groups. In the aprotinin group (study group) (n = 10) the drug was administered in the pulmonary artery (15,000 KIU/min) via the pulmonary artery catheter. The control group (n = 10) received only placebo. Blood gas measurements, respiratory function tests, malondialdehyde (MDA), nitric oxide (NO), C4 and leukocyte counts were determined as parameters. Blood samples were taken before and after cross clamping. Lung biopsies were taken before and after CPB.


RESULTS
In the aprotinin group, forced expiratory volume (FEV1) and paCO2 values were better than in the control group. The postclamping MDA value in the study group was 20.6 +/- 8.7 etamol/ml and in the control group 37.5 +/- 9.6 etamol/ ml. The post clamping NO value in the study group was 261.9 micromol/l and in the control group 147.20 +/- 27.6 micromol/l. C4 levels were found to be better in the study group than in the control group: reduced levels of C4 were found to be statistically significant (study group postclamping: 12.98 +/- 2.63 mg/dl vs. control group 20.6 +/- 11.81 mg/dl). The increase in leukocyte count was found to be statistically significant (12.63 +/- 3.83 x 10(3) vs. 7.27 +/- 1.72 x 10(3). The difference between the preoperative and postoperative FEV1 in the control group was statistically significant. A statistically significant difference was found in the postoperative FEV1 in both groups.


CONCLUSIONS
Aprotinin administered in the pulmonary artery during CPB had a protective effect against lung damage after open-heart surgery.
Erdogan
Mustafa
M
Gazi University Faculty of Medicine, Cardiovascular Surgery Department, Ankara, Turkey.
Kalaycioglu
Sedat
S
Iriz
Erkan
E
D007611:Aprotinin / Q000008:administration & dosage / Q000627:therapeutic use*; D001706:Biopsy; D001784:Blood Gas Analysis; D002315:Cardiopulmonary Bypass / Q000009:adverse effects; D003176:Complement C3 / Q000032:analysis; D003181:Complement C4 / Q000032:analysis; D001026:Coronary Artery Bypass; D005260:Female; D006490:Hemostatics / Q000008:administration & dosage / Q000627:therapeutic use; D006801:Humans; D007261:Infusions, Intra-Arterial; D007958:Leukocyte Count; D008168:Lung / Q000473:pathology; D008297:Male; D008315:Malondialdehyde / Q000097:blood; D008875:Middle Aged; D009569:Nitric Oxide / Q000097:blood; D011651:Pulmonary Artery; D015427:Reperfusion Injury / Q000517:prevention & control*; D012128:Respiratory Distress Syndrome / Q000517:prevention & control*; D012129:Respiratory Function Tests; D015842:Serine Proteinase Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use*; D016896:Treatment Outcome
D003176:Complement C3; D003181:Complement C4; D006490:Hemostatics; D015842:Serine Proteinase Inhibitors; D009569:Nitric Oxide; D008315:Malondialdehyde; D007611:Aprotinin