The efficacy of aprotinin in arterial switch operations in infants

Anesthesia and Analgesia
Chinnamuthu MurugesanKanchi Muralidhar

Abstract

In the present study we assessed whether aprotinin at a total dose (40,000 kallikrein inhibitor units (KIU)/kg) is effective in reducing postoperative blood loss and blood product requirement after arterial switch operations in infants. A prospective, double-blind, randomized study, evaluated 50 infants who underwent arterial switch operations for transposition of great arteries. Patients were randomized into a placebo group, 25 patients who received normal saline and a treatment group, 25 patients who received 20,000 KIU/kg of aprotinin after induction of anesthesia, followed by 20,000 KIU/kg of aprotinin added to pump prime. Postoperative blood loss through the thoracic chest tubes and blood product requirements (mL/kg/24 h) were measured for the first 24 h in the intensive care unit. Postoperative blood loss in the first 24 h was significantly (P < 0.0001) higher in the placebo group (49.7 +/- 11.9 mL/kg/24 h) as compared to the aprotinin group (37.1 +/- 3.5 mL/kg/24 h). Requirements for fresh frozen plasma (mL/kg/24 h) and use of platelet concentrate transfusion (mL/kg/24 h) were significantly less in patients who received aprotinin (P < 0.0001), but did not reduce the proportion of patients transfused with blood products. ...Continue Reading

References

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Nov 21, 2007·The Journal of Thoracic and Cardiovascular Surgery·Carl L BackerConstantine Mavroudis
Jan 11, 2008·Paediatric Anaesthesia·Andrea SzékelyAndrás Szatmári

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Citations

May 6, 2010·Annals of Cardiac Anaesthesia·Yashwant S VermaSambhu N Das
Nov 19, 2013·Paediatric Anaesthesia·Philip D Arnold
Mar 20, 2009·Current Opinion in Anaesthesiology·Wulf Dietrich
Aug 6, 2015·European Journal of Anaesthesiology·UNKNOWN European Society of Anaesthesiology task force reports on place of aprotinin in clinical anaesthesia
Jul 1, 2021·Seminars in Thrombosis and Hemostasis·Nadia Thrane HovgesenAnne-Mette Hvas

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