Abstract
Aprotinin significantly decreases postoperative blood loss, yet its exact mechanism of action remains unproven. To study the cytoprotective effect on platelets, we collected blood samples from patients during cardiopulmonary bypass (CPB) operations performed with or without aprotinin. Analysis included whole-blood flow cytometry. The highest percentages of activated platelets (positive for GMP-140 expression) were bound to leukocytes and erythrocytes in all CPB patients. Platelet-platelet activation did not reveal any marked differences between groups. However, in the platelet-cell bound region, increased ristocetin-stimulated platelet activation was observed from 30 minutes on CPB to 90 minutes after CPB with aprotinin (11.9% +/- 5.1% to 33.1% +/- 8.6%; p < 0.05), but not without aprotinin (17.5% +/- 0.1% to 17.9% +/- 2.3%). Platelet autoactivation increased more in the untreated group with time on CPB. This study demonstrates that in the presence of aprotinin, platelets remain unstimulated during CPB and the von Willebrand GPIb-mediated activatability of platelets is preserved, thus maintaining a viable platelet population. Most important, this study reveals that these mechanisms are more related to platelet-leukocyte than to...Continue Reading
References
Mar 1, 1992·The Annals of Thoracic Surgery·J LaveeR Mohr
Jul 1, 1993·The Journal of Thoracic and Cardiovascular Surgery·H HuangW Zhang
Feb 1, 1995·Investigative Radiology·M J KozaR Pifarre
Aug 15, 1994·Thrombosis Research·N O SolumS Funderud
Citations
Jan 16, 2002·The Annals of Thoracic Surgery·R C LandisK M Taylor
Feb 5, 2004·The Annals of Thoracic Surgery·Yuichiro KaminishiYuzuru Sakakibara
Feb 4, 1999·The Annals of Thoracic Surgery·A Weerasinghe, K M Taylor
Sep 23, 2003·The Journal of Thoracic and Cardiovascular Surgery·Masashi TanakaTakashi Ino
Feb 20, 2003·Thrombosis Research·Marcus E CarrPhilip E Greilich
Jun 20, 1998·British Journal of Haematology·S Bannan, P G Martin
Nov 28, 2001·Artificial Organs·M TanakaT Ino
May 7, 2002·Critical Care Medicine·Vibeke Brix-ChristensenHanne Berg Ravn
Aug 20, 2003·Journal of Neurosurgery·Celia C D'ErricoKarin M Muraszko
Oct 27, 2006·Pharmacotherapy·Kyle A WeantWendell S Akers
Sep 1, 1999·Journal of Cardiothoracic and Vascular Anesthesia·L Shore-Lesserson
Jan 6, 2000·Journal of Cardiothoracic and Vascular Anesthesia·C C D'ErricoE L Bove
Aug 5, 2000·The Journal of Thoracic and Cardiovascular Surgery·M PoullisR C Landis
Mar 23, 1999·The Annals of Thoracic Surgery·K KawahitoK Fuse
Nov 28, 2001·The Annals of Thoracic Surgery·R C LandisK M Taylor
Mar 16, 2001·Expert Opinion on Pharmacotherapy·P P PunjabiK M Taylor
May 17, 2001·Scandinavian Cardiovascular Journal : SCJ·M WeiM Tarkka
Feb 11, 1999·Anesthesia and Analgesia·F IchinoseS Morita
Mar 29, 2000·Anesthesia and Analgesia·S A Kozek-LangeneckerA K Cheung
Jan 29, 2002·Anesthesia and Analgesia·Gregory A NuttallMark H Ereth
Jan 1, 1997·Journal of Clinical Apheresis·M Pavlovsky, R Weinstein
Jan 7, 2000·Anesthesia and Analgesia·S A Kozek-LangeneckerA K Cheung
Jul 9, 2004·Orthopedics·Jerrold H Levy, Edward Sypniewski
Oct 7, 1997·Chest·S WanJ L Vincent