Low dose aprotinin and low dose tranexamic acid in elective cardiac surgery with cardiopulmonary bypass.
The antifibrinolytic agents aprotinin and tranexamic acid have both been proven to be efficient in reducing postoperative blood loss and transfusion requirements in patients in cardiac surgery. In light of recent safety issues regarding aprotinin, this single-centre study compared efficacy and safety of low dose aprotinin (2 million KIU, pump-prime volume only) and low dose tranexamic acid (1 g, pump-prime volume) in 708 consecutive patients from two prospective registers undergoing elective cardiac procedures with cardiopulmonary bypass (CPB). Incidences of postoperative complications showed no significant differences between groups. Postoperative blood loss and transfusion requirements were significantly lower in aprotinin compared to tranexamic acid patients. Overall, both antifibrinolytic low dose regimens are safe components of perioperative patient management in elective cardiac surgery with CPB. Cardiac procedures requiring longer CPB times might benefit from the administration of low dose aprotinin.
Waldow
Thomas
T
Herzzentrum Dresden, Universitätsklinik, Klinik für Kardiochirurgie, TU Dresden, D-01307 Dresden, Germany.
Krutzsch
Diana
D
Wils
Michael
M
Plötze
Katrin
K
Matschke
Klaus
K
D000368:Aged; D007611:Aprotinin / Q000008:administration & dosage / Q000627:therapeutic use*; D001803:Blood Transfusion; D006348:Cardiac Surgical Procedures; D002315:Cardiopulmonary Bypass; D017558:Elective Surgical Procedures; D005260:Female; D006490:Hemostatics / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019106:Postoperative Hemorrhage / Q000188:drug therapy*; D011446:Prospective Studies; D014148:Tranexamic Acid / Q000008:administration & dosage / Q000627:therapeutic use*
D006490:Hemostatics; D014148:Tranexamic Acid; D007611:Aprotinin