PMID: 7539609Jun 1, 1995Paper

Half-dose aprotinin preserves hemostatic function in patients undergoing bypass operations

The Annals of Thoracic Surgery
B LiuD Roberts

Abstract

High-dose aprotinin reduces bleeding in cardiac operations but with potential side-effects and increased cost. It is therefore mandatory that the effectiveness of a low dose be investigated. Half of the Hammersmith regimen was studied in cardiac surgical patients to find out how it could reduce bleeding. Blood fibrinolysis parameters were studied in 40 elective patients undergoing coronary artery bypass grafting in a double-blind, placebo-controlled study design. The plasma activities of tissue plasminogen activator, plasminogen activator inhibitor, alpha 2-antiplasmin, plasminogen, fibrinogen, and D-dimer as well as platelet number, bleeding times, activated clotting time, and aprotinin plasma concentrations were assessed before, during, and after the operation. Fibrinolysis was inhibited by aprotinin as evidenced by decreased D-dimer (p = 0.0001) and tissue plasminogen activator (p = 0.0432) levels and increased plasminogen activator inhibitor (p = 0.0105) and alpha 2-antiplasmin (p = 0.0002) levels during the operation. A postoperative abnormal bleeding time occurred 38% more frequently in the placebo group (p < 0.05). Aprotinin plasma concentrations reached adequate levels to inhibit plasmin and plasma kallikrein. This stud...Continue Reading

References

Dec 1, 1992·The Annals of Thoracic Surgery·D M CosgroveF D Loop
Feb 1, 1992·Blood Coagulation & Fibrinolysis : an International Journal in Haemostasis and Thrombosis·G FuhrerH E Hoffmeister
Jan 1, 1991·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·E CovinoN Spampinato
Oct 1, 1991·Journal of Cardiothoracic and Vascular Anesthesia·G MarxV Tilsner
Dec 1, 1987·The Annals of Thoracic Surgery·W van OeverenC R Wildevuur
Jan 1, 1989·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·C R WildevuurW van Oeveren
Jan 1, 1994·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·N TabuchiW van Oeveren
Jan 1, 1993·Scandinavian Journal of Thoracic and Cardiovascular Surgery·B LiuG William-Olsson
May 1, 1993·The Annals of Thoracic Surgery·M KawasujiY Watanabe

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Citations

Oct 31, 1998·The Japanese Journal of Thoracic and Cardiovascular Surgery : Official Publication of the Japanese Association for Thoracic Surgery = Nihon Kyōbu Geka Gakkai Zasshi·M OsakaH Ohuchi
Mar 27, 1998·American Journal of Surgery·Y OzoğulI Sayek
Oct 13, 1998·The Annals of Thoracic Surgery·M MisfeldH H Sievers
Mar 16, 2001·Expert Opinion on Pharmacotherapy·P P PunjabiK M Taylor
Aug 1, 1997·The Journal of Thoracic and Cardiovascular Surgery·N HayashidaS Aoyagi
Jul 25, 2003·Asian Cardiovascular & Thoracic Annals·Yongzhi DengHugh S Paterson
Nov 30, 1999·Anesthesia and Analgesia·C J O'ConnorK J Tuman
Oct 10, 1997·Anesthesia and Analgesia·C J O'ConnorK J Tuman

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