Low-Dose Aprotinin Effect on Hemostasis After Cardiopulmonary Bypass

체외 순환후 지혈에 대한 저농도의 Aprotinin 효과

  • Lee, Seon-Hui (Dept.of Thoracic and Cardiovascular Surgery, Catholic University Medical College) ;
  • Choe, Seung-Ho (Dept.of Thoracic and Cardiovascular Surgery, Catholic University Medical College) ;
  • Gwak, Mun-Seop
  • 이선희 (가톨릭대학교 의과대학 흉부외과학교실) ;
  • 최승호 (가톨릭대학교 의과대학 흉부외과학교실) ;
  • 곽문섭
  • Published : 1996.02.01

Abstract

The effect of low-dose aprotinin on hemostasis in patients undergoing cardiopulmonary bypass (CPB) for repeat valve replacement and coronary artery bypass operations were investigated. Thirty patients undergoing elective CPB from February 1993 through February 1995 at Catholic Medical Center were studied. the patients were randomly divided into two groups(15 patients per group) : group 1, receive 1, 000, 000 KIU/kg aprotinin in the CPB priming volume and 20, 000 KIU/kg aprotinin intravenously each hour during CPB ; group 2, without aprotinin administration served as the controls. The result showed that the early postoperative (during the first 24 hours) and mean postoperative total blood loss of the aprotinin group were significantly reduced than the control group (317.2 $\pm$ 89.6ml in the aprotinin group versus 821.3 $\pm$ 441.2rnl in the control group, p<0.01 ; 767.2 $\pm$ 214.1 ml in the aprotinin group versus 1562.5 $\pm$ 735.2 rnl in the control gorup, p<0.01). Total use of packed red ells and fresh frozen plasma was higher in control group(1.22 $\pm$ 0.3 units versus 4.21 $\pm$ 1.7units of packed red cells, p<0.01 : and 2.37 $\pm$ 0.4units versus 6.72 $\pm$ 0.88uni1s of fresh prozen plasma, p<0.05). We conclude the low-dose aprotinin was positive influence on postoperative blood loss in undergoing highly bleeding potency cardiac operation.

Keywords

References

  1. Ann Thorac Surg v.55 Effects of aprotinin on anticoagulant monitoring : implication in cardiovascular surgery David,M.N.;Jeanine,M.W.;Jawed,F.;Rogue,P.
  2. 대흉외지 v.26 재 개심술시 aprotinin의 지혈효과에 대한 고찰 홍인수;차경태;안욱수;허용;김병열;이정호
  3. 재 개심술후의 출혈과 수혈에 대한 다량의 aprotinin의 효과: 개심술시 자가수혈(1판) 홍용우;김진경;박정현
  4. Brug Res v.33 Biochemistry and application of apropine, the Kallikrein inhibitor from bovine organs Fritz,H.;Wunderer,G.
  5. N Engl J Med v.317 Transfusion-associated hepatitis and AIDS Bove,J.R.
  6. J Thorac Cardiovasc Surg v.109 Thoraxcenter blood interaction Tabuchi,N.;De Haan,J.;Van Oeveren,W.
  7. Ann Thorac Surg v.55 Effect of low-dose aprotinin on coagulation and fibrinolysis in cardiopulmonary bypass Kawasaji,M.;Ueyama,K.;Naoki,S.(et al.)
  8. Anesthesiology v.73 Influence of high-dose aprotinin treatment on blood loss and coagulation patterns in patients undergoing myocardial revascularization Dietrich,W.;Spannagl.M.;Jochum,M.(et al.)
  9. Ann Thorac Surg v.55 Renal dysfunction and intravascular coagulation with aprotinin and hypothermic circulatory arrest Thoralf,M.S.;Nicholas,T.K.;Jeffrey,E.S.(et al.)
  10. Ann Thorac Surg v.44 Effect of aprotinin on hemostatic mechanisms during cardiopulmonary bypass Van oeveren,W.;Jansen,N.J.G.;Bidstrup,B.P.(et al.)
  11. Thromb Haemost v.66 Hemostasis in Patients undergoing extracorporeal circulation ; the effect of aprotinin Lu,H.;Soria,C.;Commin,P.L.(et al.)
  12. Lancet v.337 Low-dose aprotinin for reduction of blood loss after cardiopulmonary bypass Carrel,J.;Bauer,E.;Laske,A.;Von Segesser,L.;Jurina,M.
  13. 약리학강의(1판) 이우주