PMID: 9527193Apr 4, 1998Paper

High-dose epsilon-aminocaproic acid versus aprotinin: antifibrinolytic efficacy in first-time coronary operations

The Annals of Thoracic Surgery
B EberleH Oelert

Abstract

The antifibrinolytic efficacy of a high-dose regimen of epsilon-aminocaproic acid (epsilon-ACA) was compared with aprotinin in first-time coronary operations. In a prospective, double-blinded, randomized study, 20 patients received high-dose epsilon-ACA (10 g both as a loading and cardiopulmonary bypass priming dose, 2.5 g/h until 4 hours after protamine), and another 20 patients received aprotinin (2 x 10(6) KIU [280 mg] for loading and priming, 0.5 x 10(6) KIU/h [70 mg/h]). Ten untreated patients served as controls. Both agents reduced postoperative levels of thrombin/antithrombin III complexes, D-dimers, fibrin degradation products, free plasma hemoglobin (epsilon-ACA versus aprotinin, p = not significant; p < 0.05 versus controls), and amount of retransfused autologous blood (p < 0.001). Epsilon-ACA increased, aprotinin suppressed antiplasmin-plasmin complex generation (epsilon-ACA versus controls, p < 0.02; epsilon-ACA versus AP, p < 0.0001). For 4 hours after discontinuation, more chest drainage occurred with epsilon-ACA than aprotinin (137 +/- 90 mL versus 62 +/- 29 mL; means +/- standard deviation; p < 0.02). Cumulative 12-hour drainage was similar for aprotinin (391 +/- 220 mL) and epsilon-ACA (582 +/- 274 mL), but hig...Continue Reading

Citations

Nov 5, 2003·Spine·Jennifer W ColeLawrence G Lenke
Mar 16, 2001·Expert Opinion on Pharmacotherapy·P P PunjabiK M Taylor
Aug 4, 2001·The Annals of Pharmacotherapy·B L Erstad
Apr 24, 2004·Anesthesia and Analgesia·Michael J EissesWayne L Chandler
Sep 4, 2007·American Journal of Veterinary Research·Julie RossRaymond W Sweeney
Sep 28, 2016·European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society·Guang LiChao Zhang
Apr 17, 2001·Blood Coagulation & Fibrinolysis : an International Journal in Haemostasis and Thrombosis·M J RayN Marsh
Aug 9, 2005·Journal of Cardiothoracic and Vascular Anesthesia·Wayne L Chandler

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