Fibrinolytic activity and bleeding after cardiac surgery with cardiopulmonary bypass and low-dose aprotinin therapy

Blood Coagulation and Fibrinolysis

Volumn 14, Issue 2, 2003, Pages 147-153

  Kuepper, Frank ^a,b   Dangas, George ^b   Mueller Chorus, Ansgar ^a   Kulka, Peter M ^a   Zenz, Michael ^a   Wiebalck, Albrecht ^a  

^a RUHR UNIVERSITY BOCHUM   (Germany)

^b CARDIOVASCULAR RESEARCH FOUNDATION   (United States)

Author keywords

Bleeding complications; Cardiac surgery; Cardiopulmonary bypass; D dimers; Fibrinolysis; Hyperfibrinolysis; Low dose aprotinin

Indexed keywords

APROTININ; D DIMER;

ADULT; AGED; ANESTHESIA INDUCTION; ARTICLE; BLEEDING; CARDIOPULMONARY BYPASS; CLINICAL TRIAL; CONTROLLED CLINICAL TRIAL; CONTROLLED STUDY; DOSE RESPONSE; FEMALE; FIBRINOLYSIS; HEART SURGERY; HUMAN; MAJOR CLINICAL STUDY; MALE; PERIOPERATIVE PERIOD; POSTOPERATIVE COMPLICATION; PRIORITY JOURNAL; PROTEIN BLOOD LEVEL; PROTEIN DETERMINATION; RANDOMIZED CONTROLLED TRIAL; REFERENCE VALUE; RISK ASSESSMENT; SINGLE BLIND PROCEDURE; SKIN INCISION;

ADULT; AGED; APROTININ; BLOOD COAGULATION; BLOOD LOSS, SURGICAL; CARDIAC SURGICAL PROCEDURES; CARDIOPULMONARY BYPASS; DRUG ADMINISTRATION SCHEDULE; FIBRIN FIBRINOGEN DEGRADATION PRODUCTS; FIBRINOLYSIS; HUMANS; MALE; POSTOPERATIVE COMPLICATIONS; POSTOPERATIVE HEMORRHAGE; PROSPECTIVE STUDIES; REGRESSION ANALYSIS; ROC CURVE; SINGLE-BLIND METHOD; TRYPSIN INHIBITORS;

EID: 0037297389     PISSN: 09575235     EISSN: None     Source Type: Journal    
DOI: 10.1097/00001721-200302000-00005     Document Type: Article

References (27)

1. Munoz JJ, Birkmeyer NJ, Birkmeyer JD, O'Connor GT, Dacey LJ. Is epsilon-aminocaproic acid as effective as aprotinin in reducing bleeding with cardiac surgery?: a meta-analysis. Circulation 1999; 99:81-89.
2. Levy JH, Pifarre R, Schaff HV, Horrow JC, Albus R, Spiess B, et al. A multicenter, double-blind, placebo-controlled trial of aprotinin for reducing blood loss and the requirement for donor-blood transfusion in patients undergoing repeat coronary artery bypass grafting. Circulation 1995; 92:2236-2244.
3. Goodnough LT, Despotis GJ. Future directions in utilization review: the role of transfusion algorithms. Transfus Sci 1998; 19:97-105.
4. Levi M, Cromheecke ME, de Jonge E, Prins MH, de Mol BJ, Briet E, et al. Pharmacological strategies to decrease excessive blood loss in cardiac surgery: a meta-analysis of clinically relevant endpoints. Lancet 1999; 354:1940-1947.
5. Murphy PJ, Connery C, Hicks GL Jr, Blumberg N. Homologous blood transfusion as a risk factor for postoperative infection after coronary artery bypass graft operations. J Thorac Cardiovasc Surg 1992; 104:1092-1099.
6. Greenbaum BH. Transfusion-associated graft-versus-host disease: historical perspectives, incidence, and current use of irradiated blood products. J Clin Oncol 1991; 9:1889-1902.
7. Dodd RY. The risk of transfusion-transmitted infection. N Engl J Med 1992; 327:419-421.
8. Donahue JG, Munoz A, Ness PM, Brown DE Jr, Yawn DH, McAllister HA Jr, et al. The declining risk of post-transfusion hepatitis C virus infection. N Engl J Med 1992; 327:369-373.
9. Jamieson WR, Dryden PJ, O'Connor JP, Sadeghi H, Ansley DM, Merrick PM, Beneficial effect of both tranexamic acid and aprotinin on blood loss reduction in reoperative valve replacement surgery. Circulation 1997; 96:II-96-II-100, discussion II-100-II-101.
10. Ray MJ, Brown KF, Burrows CA, O'Brien MF. Economic evaluation of high-dose and low-dose aprotinin therapy during cardiopulmonary bypass. Ann Thorac Surg 1999; 68:940-945.
11. Nuttall GA, Oliver WC, Ereth MH, Santrach PJ. Coagulation tests predict bleeding after cardiopulmonary bypass. J Cardiothorac Vasc Anesth 1997; 11:815-823.
12. Dorman BH, Spinale FG, Bailey MK, Kratz JM, Roy RC. Identification of patients at risk for excessive blood loss during coronary artery bypass surgery: thromboelastography versus coagulation screen. Anesth Analg 1993; 76:694-700.
13. Despotis GJ, Skubas NJ, Goodnough LT. Optimal management of bleeding and transfusion in patients undergoing cardiac surgery. Semin Thorac Cardiovasc Surg 1999; 11:84-104.
14. Speekenbrink RG, Wildevuur CR, Sturk A, Eijsman L. Low-dose and high-dose aprotinin improve hemostasis in coronary operations. J Thorac Cardiovasc Surg 1996; 112:523-530.
15. Ray MJ, Marsh NA, Hawson GA. Relationship of fibrinolysis and platelet function to bleeding after cardiopulmonary bypass. Blood Coagul Fibrinolysis 1994; 5:679-685.
16. Ashraf S, Tian Y, Cowan D, Nair U, Chatrath R, Saunders NR, et al. 'Low-dose' aprotinin modifies hemostasis but not proinflammatory cytokine release. Ann Thorac Surg 1997; 63:68-73.
17. Dietrich W, Schopf K, Spannagl M, Jochum M, Braun SL, Meisner H. Influence of high- and low-dose aprotinin on activation of hemostasis in open heart operations. Ann Thorac Surg 1998; 65:70-77, discussion 77-78.
18. Misfeld M, Dubbert S, Eleftheriadis S, Siemens HJ, Wagner T, Sievers HH. Fibrinolysis-adjusted perioperative low-dose aprotinin reduces blood loss in bypass operations. Ann Thorac Surg 1998; 66:792-799.
19. Ray MJ, Hales M, Marsh N. Epsilon-aminocaproic acid promotes the release of alpha2-antiplasmin during and after cardiopulmonary bypass. Blood Coagul Fibrinolysis 2001; 12:129-135.
20. Santamaria A, Mateo J, Oliver A, Litvan H, Murillo J, Souto JC, et al. The effect of two different doses of aprotinin on hemostasis in cardiopulmonary bypass surgery: similar transfusion requirements and blood loss. Haematologica 2000; 85:1277-1284.
21. Mastroroberto P, Chello M, Zofrea S, Marchese AR. Suppressed fibrinolysis after administration of low-dose aprotinin: reduced level of plasmin-alpha2-plasmin inhibitor complexes and postoperative blood loss. Eur J Cardiothorac Surg 1995; 9:143-145
22. Kawasuji M, Ueyama K, Sakakibara N, Tedoriya T, Matsunaga Y, Misaki T, et al. Effect of low-dose aprotinin on coagulation and fibrinolysis in cardiopulmonary bypass. Ann Thorac Surg 1993; 55:1205-1209.
23. Reber G, de Moerloose P. D-dimer assays for the exclusion of venous thromboembolism. Semin Thromb Hemost 2000; 26:619-624
24. Nuttall GA, Oliver WC, Santrach PJ, Bryant S, Dearani JA, Schaff HV, et al. Efficacy of a simple intraoperative transfusion algorithm for nonerythrocyte component utilization after cardiopulmonary bypass. Anesthesiology 2001; 94:773-781, discussion 775A-776A.
25. Ereth MH, Nuttall GA, Klindworth JT, MacVeigh I, Santrach PJ, Orszulak TA, et al. Does the platelet-activated clotting test (HemoSTATUS) predict blood loss and platelet dysfunction associated with cardiopulmonary bypass? Anesth Analg 1997; 85:259-264.
26. Dempfle CE. The use of soluble fibrin in evaluating the acute and chronic hypercoagulable state. Thromb Haemost 1999; 82:673-683.
27. Wahba A, Black G, Koksch M, Rothe G, Preuner J, Schmitz G, et al. Aprotinin has no effect on platelet activation and adhesion during cardiopulmonary bypass. Thromb Haemost 1996; 75:844-848.