title: Assessment of aprotinin in the reduction of inflammatory systemic response in children undergoing surgery with cardiopulmonary bypass.
abstract: OBJECTIVE
  To evaluate if the hemostatic high-dose aprotinin seems to reduce the inflammatory process after extracorporeal circulation (ECC) in children.
  
  
  METHODS
  A prospective randomized study was conducted on children aged 30 days to 4 years submitted to correction of acyanogenic congenital heart disease with ECC and divided into two groups: Control (n=9) and Aprotinin (n=10). In the Aprotinin Group the drug was administered before and during ECC and the systemic inflammatory response and hemostatic and multiorgan dysfunctions were analyzed on the basis of clinical and biochemical markers. Differences were considered to be significant when P<0.05.
  
  
  RESULTS
  The groups were similar regarding demographic and intraoperative variables, except for a greater hemodilution in the Aprotinin Group. The drug had no benefit regarding time of mechanical pulmonary ventilation, permanence in the postoperative ICU and length of
  
  
  CONCLUSIONS
  In this series, hemostatic high-dose aprotinin did not minimize the clinical manifestations or serum markers of the inflammatory systemic response.
authors.affiliation: Clinics Hospital, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil. cesarmonica@directnet.com.br
authors.forename: Cesar Augusto
authors.initials: CA
authors.lastname: Ferreira
authors.forename: Walter Villela de Andrade
authors.initials: WV
authors.lastname: Vicente
authors.forename: Paulo Roberto Barbosa
authors.initials: PR
authors.lastname: Evora
authors.forename: Alfredo José
authors.initials: AJ
authors.lastname: Rodrigues
authors.forename: Jyrson Guilherme
authors.initials: JG
authors.lastname: Klamt
authors.forename: Ana Paula de Carvalho Panzeli
authors.initials: AP
authors.lastname: Carlotti
authors.forename: Fábio
authors.initials: F
authors.lastname: Carmona
authors.forename: Paulo Henrique
authors.initials: PH
authors.lastname: Manso
mesh_terms: D000893:Anti-Inflammatory Agents / Q000494:pharmacology; D007611:Aprotinin / Q000494:pharmacology*; D002315:Cardiopulmonary Bypass / Q000009:adverse effects / Q000379:methods*; D002675:Child, Preschool; D005260:Female; D006330:Heart Defects, Congenital / Q000601:surgery*; D006801:Humans; D007223:Infant; D018836:Inflammation Mediators / Q000097:blood*; D007378:Interleukins / Q000097:blood; D008297:Male; D011183:Postoperative Complications / Q000517:prevention & control*; D015842:Serine Proteinase Inhibitors / Q000494:pharmacology; D018746:Systemic Inflammatory Response Syndrome / Q000175:diagnosis / Q000517:prevention & control*; D014409:Tumor Necrosis Factor-alpha / Q000097:blood
chemical_list: D000893:Anti-Inflammatory Agents; D018836:Inflammation Mediators; D007378:Interleukins; D015842:Serine Proteinase Inhibitors; D014409:Tumor Necrosis Factor-alpha; D007611:Aprotinin