The critical role of aprotinin in controlling haemostasis in conjunction with non-pharmacological blood-saving strategies during routine coronary artery bypass surgery

European Journal of Medical Research

Volumn 11, Issue 9, 2006, Pages 386-393

  Khalil, Philipe N ^a   Siebeck, M ^a   Ismail, M ^b   Khalil, M N ^a   von Knobelsdorff, G ^b   Marx, G ^b   Kalmar, P ^b  

^a LUDWIG MAXIMILIANS UNIVERSITY   (Germany)

^b UNIVERSITY MEDICAL CENTER HAMBURG EPPENDORF   (Germany)

Author keywords

Aprotinin; Blood loss; Cardiovascular; Coronary artery; Extracorporeal circulation; Kallikrein inhibitor; Surgery

Indexed keywords

APROTININ;

ADULT; AGED; ARTICLE; BLOOD AUTOTRANSFUSION; CONTROLLED STUDY; CORONARY ARTERY BYPASS GRAFT; DEEP VEIN THROMBOSIS; DRUG EFFICACY; DRUG HYPERSENSITIVITY; DRUG MEGADOSE; DRUG SAFETY; ELECTIVE SURGERY; FEMALE; HEART INFARCTION; HEMODILUTION; HEMOSTASIS; HUMAN; INTERMETHOD COMPARISON; KIDNEY FAILURE; LUNG EMBOLISM; MAJOR CLINICAL STUDY; MALE; NEPHROTOXICITY; PEROPERATIVE CARE; PEROPERATIVE COMPLICATION; POSTOPERATIVE CARE; POSTOPERATIVE HEMORRHAGE; RETROSPECTIVE STUDY;

ADULT; AGED; APROTININ; BLOOD LOSS, SURGICAL; BLOOD TRANSFUSION; CORONARY ARTERY BYPASS; FEMALE; HEMOSTASIS; HUMANS; INTRAOPERATIVE CARE; MALE; MIDDLE AGED; RETROSPECTIVE STUDIES; SERINE PROTEINASE INHIBITORS;

EID: 33750044839     PISSN: 09492321     EISSN: None     Source Type: Journal    
DOI: None     Document Type: Article

References (39)

1. Dacey LJ, Munoz JJ, Baribeau YR, Johnson ER, Lahey SJ, Leavitt BJ, Quinn RD, Nugent WC, Birkmeyer JD, O'Connor GT. Reexploration for hemorrhage following coronary artery bypass grafting: incidence and risk factors. Northern New England Cardiovascular Disease Study Group. Arch Surg 1998; 133: 442-447.
2. Levi M, Cromheecke ME, de Jonge E, Prins MH, de Mol BJM, Brier E, Buller HR. Pharmacological strategies to decrease excessive blood loss in cardiac surgery: a meta-analysis of clinically relevant endpoints. Lancet 1999, 354:1940-1947.
3. Unsworth-White MJ, Herriot A, Valencia O. Resternotomy for bleeding after cardiac operation: a marker for increase morbidity and mortality. Ann Thorac Surg 1995; 59: 664-667.
4. Bick RL. Hemostasis defects associated with cardiac surgery, prosthetic devices and extracorporeal circuits. Semin Thromb Hemost 1985; 11: 249-280.
5. Harker LA. Bleeding after cardiopulmonary bypass. N Engl J Med 1986; 314: 446-448.
6. Harker LA, Malpass TW, Branson HE, Hessel EA II, Slichter SJ. Mechanism of abnormal bleeding in patients undergoing cardiopulmonary bypass: acquired transident platelet dysfunkdon associated with selective alpha-granule release. Blood 1980; 56: 824-834.
7. Mammen EF, Koetes MH, Washington BC, Wolk LW, Brown JM, Burdick M, Selik NR, Wilson RF. Hemostasis changes during cardiopulmonary bypass surgery. Semin Thromb Hemost 1985; 11: 281-292.
8. Teufelsbauer H, Proidl S, Havel M, Vukovich T. Early activation of hemostasis during cardiopulmonary bypass: evidence for thrombin mediated hyperfibrinolysis. Thromb Haemost 1992; 68: 250-252.
9. Royston D. High-dose aprotinin therapy: a review of the first five years experience. J Cardiothorac Vasc Anesth 1992; 6: 76-100.
10. Fremes SE, Wong BI, Lee E, Mai R, Christakis GT, McLean RF, Goldman BS, Naylor CD. Metaanalysis of prophylactic drug treatment in the prevention of postoperative bleeding. Ann Thorac Surg 1994; 58: 1580-1588.
11. Laupacis A, Fergusson D, for The International Study of Peri-operative Transfusion (ISPOT) Investigators. Drugs to minimize perioperative blood loss in cardiac surgery: meta-analyses using perioperative blood transfusion as the outcome. Anesth Analg. 1997; 85: 1258-1267.
12. Blauhaupt B, Gross C, Necek S, Doran JE, Spath E, Lundsgaardhausen P. Effects of high-dose aprotinin on blood loss, platelet function, fibrinolysis, complement and renal function after cardiopulmonary Bypass. J Thorac Cardiovasc Surg 1991; 101: 958-967.
13. Huang H, Ding W, Su W, Zhang W. Mechanism of the preserving effect of aprotinin on platelet function and its use in cardic surgery. J Thorac Cardiovasc Surg 1993; 106: 11-18.
14. Kallis P, Tooze JA, Talbot S, Cowans D, Bevan DH, Treasure T. Aprotinin inhibits fibrinolysis, improves platelet adhesion and reduces blood loss: results of a double-blind randomized clinical trial. Eur J Cardiothorac Surg. 1994; 8: 315-323.
15. Mannucci L, Gerometta PS, Mussoni L, Antona C, Parolari A, Salvi L, Bigholi P, Tremoli E. One month follow-up of haemostatic variables in patients undergoing aortocoronary bypass surgery- effect of Aprotinin. Thromb Haemost 1995; 73: 356-361.
16. Mastroroberto P, Chello M, Zofrea S, Marchese AR. Suppressed fibrinolysis after administration of low-dose aprotinin: reduced level of plasmin-alpha-2-plasmin inhibitor complexes and postoperative blood loss. Eur J Cardiothorac Surg 1995; 9: 143-145.
17. Marx G, Pokar H, Reuter H, Doering V, Tilsner V. The effects of aprotinin on hemostatic function during cardiac surgery. J Cardiothorac Vasc Anesth 1991; 5: 467-474.
18. Smith PK, Muhlbaier LH. Aprotinin: safe and effective only with the full-dose regimen. Ann Thorac Surg 1996; 62: 1575-1577.
19. Dietrich W, Schöpf 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; 56: 70-77.
20. Alvarez JM, Jackson LR, Chatwin C, Smolich JJ. Low-dose postoperative aprotinin reduces mediastional drainage and blood product use in patients undergoing primary coronary artery bypass grafting who are taking aspirin: a prospective randomized, double-blind, placebo-controlled trial. J Thorac Cardiovasc Surg 2001; 122: 457-463.
21. D'Ambra, MN, Akins CW, Blackstone EH, Bonney SL, Cohen LH, Cosgrove DM, Levy JH, Lynch KE, Maddi R. Aprotinin in primary valve replacement and reconstuction: a multicenter, double-blind, placebo-controlld trial. J Thorac Cardiovasc Surg 1996; 112: 1081-1089.
22. Hardy JF, Desroches J, Belisle S, Perrault J, Carrier M, Robitaille D. Low-dose aprotinin infusion is not clinically useful to reduce bleeding and transfusion of homologous blood products in high-risk cardiac surgical patients. Can J Anaesth 1993; 40: 625-631.
23. Lemmer JH Jr, Dilling EW, Morton JR, Rich JB, Robicsek F, Bricker DL, Hantler CB, Copeland JG III, Ochsner JL, Daily PO, Whitten CW, Noon GP, Maddi R. Aprotinin for primary coronary artery bypass grafting: a multicenter trial of three dose regimens. Ann Thorac Surg 1996; 62: 1659-1668.
24. Speckenbrink RGH, Wildevuur CRH, Sturk A, Eijsman L. Low-dose and high-dose aprotinin improve hemostasis in coronary operations. J Thorac Cardiovasc Surg 1996; 112:523-530.
25. Smith PK, Muhlbaier LH. Aprotinin: safe and effective only with the full-dose regimen (editoral). Ann Thorac Surg 1996; 62: 1575-1577.
26. Mangano DT, Tudor IC, Dietzel C. The risk associated with aprotinin in cardiac surgery. N Engl J Med 2006; 354: 353-356.
27. Birnbaum DE, Hoffmeister HE (eds). Blood saving in open heart surgery. 1990; FK Schattauer, Stuttgart-New York.
28. Boldt J, Kling D, Hempelmann G. Blood conservation in cardiac surgery-cell saving versus haemofiltration. J Cardiothorac Anesth 1989; 3 (5 Supl 1): 82.
29. Keeling MM, Gray LA Jr, Brink MA, Hillerich VK, Bland KI. Intraoperative autotransfusion. Experience in 725 consecutive cases. Ann Surg 1983; 197: 536-541.
30. Mayer ED, Welsch M, Tanzeem A, Saggau W, Spath J, Hummels R, Schmitz W. Reduction of postoperative blood requirements by use of the cell separator. Scand J Thorac Cardiovasc Surg 1985; 19: 165-171.
31. Parrot D, Lancon JP, Merle JP, Rerolle A, Bernard A, Obadia JF, Caillard B. J Cardiothorac Vasc Anesth. 1991; 5: 454-456.
32. Khalil PN, Ismail M, Kalmar P, von Knobelsdorff G, Marx G. Activation of fibrinolysis in the pericardial cavity after cardiopulmonary bypass. Thromb Haemost 2004; 92: 568-574.
33. O'Regan D, Giannopoulos N, Mediratta N, Kendall SW, Forni A, Pillai R, Westaby S. Topical aprotinin in cardiac operations. Ann Thorac Surg 1994; 58; 778-781.
34. Tatar H, Cicek S, Demirkilic U et al. Topical use of aprotinin in open heart operations. Ann Thorac Surg 1993; 55: 659-661.
35. Cicek S, Tatar H, Demirkilic U, Kuralay E. Topical use of aprotinin in cardiac surgery (letter to the editor). J Thorac Cardiovasc Surg 1995; 110: 568-569.
36. Carless PA, Moxey AJ, Stokes BJ, Henry DA. Are antifibrinolytic drugs equivalent in reducing blood loss and transfusion in cardiac surgery? a metaanalysis of randomized head-to-head trials. BMC Cardiovascular Disorder 2005; 5: 19.
37. Body SC, Birmingham J, Parks R, Ley C, Maddi R, Shernan SK, Siegel LC, Stover EP, D'Ambra MN, Levin J, Mangano DT, Spiess BD. Safety and efficacy of shed mediastinal blood transfusion after cardiac surgery: a multicenter observational study. multicenter study of perioperative ischemia research group. J Cardiothorac Vasc Anesth 1999; 13: 410-416.
38. Engles L. Review and application of serine protease inhibition in coronary artery bypass graft surgery. Am J Health Syst Pharm 2005; 62: 9-14.
39. Alderman EL, Levy JH, Rich JB, Nili M, Vidue B, Schaff H, Uretzky G, Pettersson G, Thiis JJ, Hautler CB, Chaitman B, Nadel A. Analysis of coronary graft patency after aprotinin use: results from the international multicenter aprotinin graft patency experience (image) trial. J Thorac Cardiovasc Surg 1998; 116: 716-730.