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Journals / Anestezi Dergisi / 2000 / Cilt: 8 - Sayı: 4

Effects of aprotinin on bleeding and activated clotting time in open heart surgery

Açık kalp cerrahisinde aprotininin kanama ve aktive edilmiş pıhtılaşma zamanına etkisi

Hülya EROLÇAY
Lale YÜCEYAR
Kazım BEŞİRLİ
Bora AYKAÇ
Pages
255–259
DOI
—
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AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

In the present study, ACT was found to be prolonged with aprotinin but returned to baseline after protamine infusion in both groups.

📌 3 Key Takeaways

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Objective & Hypothesis:In this study, the effects of aprotinin on hemostasis and activated clotting time (ACT) were assessed in open heart surgery.
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Key Findings & Data:Fifteen patients in the aprotinin group received an IV bolus of 2 millions KIU. aprotinin following the induction of anesthesia and an infusion of 500 000 KIU h<sup>-1</sup> was administered throughout the operation. 2 millions KIU were added to the priming volume of oxygenator.
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Conclusion & Impact:In the present study, ACT was found to be prolonged with aprotinin but returned to baseline after protamine infusion in both groups.
🔬Design:Research Article
📍Scope:Comprehensive Sample
⚙️Variables:Kanama zamanı · Hemostaz · Heparin

Abstract

In this study, the effects of aprotinin on hemostasis and activated clotting time (ACT) were assessed in open heart surgery. Thirty patients were randomly allocated to one of two groups to receive either aprotinin or saline. Fifteen patients in the aprotinin group received an IV bolus of 2 millions KIU. aprotinin following the induction of anesthesia and an infusion of 500 000 KIU h<sup>-1</sup> was administered throughout the operation. 2 millions KIU were added to the priming volume of oxygenator. The patients in the control group received 0.9% saline. ACT, blood loss, and homologous blood requirements of the groups in the first postoperative day were compared. In the aprotinin group, ACT remained longer than the control group during the cardiopulmonary bypass. However, this prolongation was significant only in the 60th and 90th minutes (p<0.01). In the first postoperative day, bleeding (p<0.01) and transfusion requirements (p<0.05) were significantly less in the aprotinin group. In the present study, ACT was found to be prolonged with aprotinin but returned to baseline after protamine infusion in both groups.

Özet

Bu çalışmada; açık kalp cerrahisinde, antifibrinolitik bir ajan olan aprotinin kullanılmasının hemostaz ve aktive edilmiş pıhtılaşma zamanı (ACT) değerleri üzerine olan etkisi araştırıldı. Çalışmaya alınan 30 olgu aprotinin verilen ve verilmeyen olmak üzere rasgele 2 gruba ayrıldı. Aprotinin verilen grup ile (indüksiyon sonrası verilen 2 milyon KIU yükleme dozunu takiben 500 000 KIU sa -1 dozunda idame ettirildi ve ayrıca oksijenatör 'priming' ine de 2 milyon KIU eklendi) verilmeyen grup; ACT değerleri, ameliyat sonrası ilk 24 saat içindeki kanama ve homolog kan transfüzyonu miktarları açısından karşılaştırıldı. Kardiyopulmoner bypass süresince; ACT, aprotinin grubunda, kontrol grubuna göre yüksek seyretti ancak 60. ve 90. dakikalardaki yükseklik anlamlıydı (p<0.01). Peroperatif kullanılan kan ürünleri (p<0.05) ile postoperatif dönemde oluşan kan kayıpları (p<0.01) ve verilen kan ürünleri (p<0.05) aprotinin grubunda daha azdı. Aprotinin kullanılan grupta ACT'nin uzadığı, ancak protamin sonrasında her iki grubun ACT değerlerinin normale döndüğünü gözlemledik.

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Cite This Article

EROLÇAY, H., YÜCEYAR, L., BEŞİRLİ, K., AYKAÇ, B. (2000). Effects of aprotinin on bleeding and activated clotting time in open heart surgery. Anestezi Dergisi, Cilt: 8 - Sayı: 4, 255–259. https://ajindex.com/articles/355399

References (15)

  1. Laders D F, Hill GE, Wong KC, Fox IJ. Blood transfusion-induced immunomodulation. Anest Analg 1996; 82: 187-204
  2. Murphy PJ, Connery C, Hicks GL, Blumberg N. Homologous blood transfusion as a risk factor for postoperative infection after coronary artery bypass graft operations. J Thorac Cardiovasc Surg 1992; 104; 1092-8, 3. Spiess BD. Hemorrhage, coagulation, and transfusion, i Cardi-othorac Vase Anest 1994; 8: 19-22
  3. Strang TI, Whitaker DK. Blood conservation strategies. Current Opinion In Anaesthesiology 1994; 7: 53-8
  4. Despotis G, Filos K, Zoys TN, Hogue CW. Factors associated with excessive postoperative blood loss and hemostatic transfusion requirements: A multivariate analysis in cardiac surgical patients. Anesth Analg 1996; 82: 13-21
  5. Oeveren W V, Jansen NJ, Bidstrup BP, Royston D. Effects of aprotinin on hemostatic mechanisms during cardiopulmonary bypass. Ann Thorac Surg 1987; 44: 640-5
  6. Tabuchi N, Njo TL, Tigehelaar 1, Huyzen RJ. Monitoring of anticoagulation in aprotinin-treated patients during heart operafions. Ann Thorac Surg 1994; 58: 774-7
  7. Mertes N, Brooke M, Van Aken H. Strategies to reduce the need for peri-operative blood transfusion. Bur i Anaesth 1997; 14 (Suppl.): 24-34
  8. Lavee J, Savion N, Smolinsky A. Platelet protection by aprotinin in cardiopulmonary bypass: Electron microscopic studv. Ann Thorac Surg 1992; 53: 477-81
  9. Marx G, Pokar H, Reuter H. The effects of aprotinin on hemostatic function during cardiac surgerv. J Cardiothorac Vase Anesth 1991; 5: 467-74
  10. Vedrinne C, Girard C, Jegaden O, Blanc P, Bouvier H. Reduction in blood use after cadiopultnonary bypass with high-dose aprotinin versus autologous fresh whole blood transfussion. J Cardiothorac Anaesth 1992; 6: 319-23
  11. Dietrich W, Barankay A, Hahnel C, Richter JA. High-dose aprotinin in cardiac surgery: Three years experience in 1784 patients. J Cardiothorac Anaesth 1992; 6: 324-7
  12. Bidstrup BP, Harrison J, Royston D, Taylor KM. Aprotinin therapy in cardiac operations: A report of use in 41 cardiac centers in the United Kingdom. Ann Thorac Surg 1993: 55: 971-6
  13. Lavee J, Ravic Z, Smolinsky A, Savion N. Platelet protection by low-dose aprotinin in cardiopulmonary bypass: Electron microscopic study. Ann Thorac Surg 1993; 55: 114-9
  14. Covino E, Pepino P, lorio D, Marino L, Ferrara P. Low-Dose aprotinin as blood saver in open heart surgery. Eur i Cardioth-oracSurg 1991; 5:414-8
  15. Liu B, Belboul A, Readberg G, Tengborn L. Effect of red