Assessment of aprotinin in the reduction of inflammatory systemic response in children undergoing surgery with cardiopulmonary bypass.
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.
Ferreira
Cesar Augusto
CA
Clinics Hospital, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil. cesarmonica@directnet.com.br
Vicente
Walter Villela de Andrade
WV
Evora
Paulo Roberto Barbosa
PR
Rodrigues
Alfredo José
AJ
Klamt
Jyrson Guilherme
JG
Carlotti
Ana Paula de Carvalho Panzeli
AP
Carmona
Fábio
F
Manso
Paulo Henrique
PH
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
D000893:Anti-Inflammatory Agents; D018836:Inflammation Mediators; D007378:Interleukins; D015842:Serine Proteinase Inhibitors; D014409:Tumor Necrosis Factor-alpha; D007611:Aprotinin