Aprotinin protects the cerebral microcirculation during cardiopulmonary bypass

Perfusion

Volumn 24, Issue 2, 2009, Pages 99-105

  Ishibashi, N ^a   Iwata, Y ^a   Zurakowski, D ^b   Lidov, H G W ^b   Jonas, Richard A ^a  

^a CHILDREN'S NATIONAL MEDICAL CENTER   (United States)

^b BOSTON CHILDREN S HOSPITAL   (United States)

Author keywords

Brain protection; Cardiopulmonary bypass; Cerebrovascular circulation; Inflammation; Microcirculation

Indexed keywords

APROTININ; CREATININE; UREA;

ANIMAL EXPERIMENT; ANIMAL MODEL; ARTICLE; BRAIN DYSFUNCTION; BRAIN MICROCIRCULATION; CARDIOPULMONARY BYPASS; CONTINUOUS INFUSION; CONTROLLED STUDY; CREATININE BLOOD LEVEL; DOSE RESPONSE; DRUG BLOOD LEVEL; DRUG RESPONSE; KIDNEY DYSFUNCTION; KIDNEY FUNCTION; LEUKOCYTE ACTIVATION; LEUKOCYTE ADHERENCE; LEUKOCYTE ROLLING; MEAN ARTERIAL PRESSURE; NEUROLOGIC EXAMINATION; NONHUMAN; POSTOPERATIVE COMPLICATION; PRIORITY JOURNAL; PROTEIN URINE LEVEL; RISK ASSESSMENT; SCORING SYSTEM; SINGLE DRUG DOSE; UREA NITROGEN BLOOD LEVEL; WARMING;

ANIMALS; APROTININ; BLOOD UREA NITROGEN; CARDIOPULMONARY BYPASS; CEREBROVASCULAR CIRCULATION; CREATININE; KIDNEY FUNCTION TESTS; LEUKOCYTES; NEUTROPHIL ACTIVATION; PROTEINURIA; SERINE PROTEINASE INHIBITORS; SWINE;

EID: 68449091882     PISSN: 02676591     EISSN: None     Source Type: Journal    
DOI: 10.1177/0267659109106701     Document Type: Article

References (25)

1. Royston, D, Bidstrup, BP, Taylor, KM, et al. Effect of aprotinin on need for blood transfusion after repeat open-heart surgery. Lancet 1987; 2: 1289-1291.
2. Landis, RC, Asimakopoulos, G, Poullis, M, et al. The antithrombotic and antiinflammatory mechanisms of action of aprotinin. Ann Thorac Surg 2001; 72: 2169-2175.
3. Poullis, M, Manning, R, Laffan, M, et al. The antithrombotic effect of aprotinin: Actions mediated via the proteaseactivated receptor 1. J Thorac Cardiovasc Surg 2000; 120: 370-378.
4. Wachtfogel, YT, Kucich, U, Hack, CE, et al. Aprotinin inhibits the contact, neutrophil, and platelet activation systems during simulated extracorporeal perfusion. J Thorac Cardiovasc Surg 1993; 106: 1-9.
5. Asimakopoulos, G, Thompson, R, Nourshargh, S, et al. An anti-inflammatory property of aprotinin detected at the level of leukocyte extravasation. J Thorac Cardiovasc Surg 2000; 120: 361-369.
6. Fergusson, DA, Hebert, PC, Mazer, CD, et al. A comparison of aprotinin and lysine analogues in high-risk cardiac surgery. N Engl J Med 2008; 358: 2319-2331.
7. Mangano, DT, Tudor, IC, Dietzel, C. The risk associated with aprotinin in cardiac surgery. N Engl J Med 2006; 354: 353-365.
8. Arnold, DM, Fergusson, DA, Chan, AK, et al. Avoiding transfusions in children undergoing cardiac surgery: A meta-analysis of randomized trials of aprotinin. Anesth Analg 2006; 102: 731-737.
9. Backer, CL, Kelle, AM, Stewart, RD, et al. Aprotinin is safe in pediatric patients undergoing cardiac surgery. J Thorac Cardiovasc Surg 2007; 134: 1421-1426.
10. Nicole, O, Docagne, F, Ali, C, et al. The proteolytic activity of tissue-plasminogen activator enhances NMDA receptor-mediated signaling. Nat Med 2001; 7: 59-64.
11. Lebeurrier, N, Liot, G, Lopez-Atalaya, JP, et al. The brain-specific tissue-type plasminogen activator inhibitor, neuroserpin, protects neurons against excitotoxicity both in vitro and in vivo. Mol Cell Neurosci 2005; 30: 552-558.
12. Iwata, Y, Nicole, O, Okamura, T, et al. Aprotinin confers neuroprotection by reducing excitotoxic cell death. J Thorac Cardiovasc Surg 2008; 135: 573-578.
13. Aoki, M, Jonas, RA, Nomura, F, et al. Effects of aprotinin on acute recovery of cerebral metabolism in piglets after hypothermic circulatory arrest. Ann Thorac Surg 1994; 58: 146-153.
14. Anttila, V, Hagino, I, Iwata, Y, et al. Aprotinin improves cerebral protection: Evidence from a survival porcine model. J Thorac Cardiovasc Surg 2006; 132: 948-953.
15. Iwata, Y, Okamura, T, Zurakowski, D, et al. Optimal dose of aprotinin for neuroprotection and renal function in a piglet survival model. J Thorac Cardiovasc Surg 2009 Jun; 137(6): 1521-1529. Epub 2009 Apr 21.
16. Duebener, LF, Hagino, I, Sakamoto, T, et al. Effects of pH management during deep hypothermic bypass on cerebral microcirculation: Alpha-stat versus pH-stat. Circulation 2002; 106: I103-I108.
17. Forbess, JM, Ibla, JC, Lidov, HG, et al. University of Wisconsin cerebroplegia in a piglet survival model of circulatory arrest. Ann Thorac Surg 1995; 60: S494-S500.
18. Shin'oka, T, Shum-Tim, D, Jonas, RA, et al. Higher hematocrit improves cerebral outcome after deep hypothermic circulatory arrest. J Thorac Cardiovasc Surg 1996; 112: 1610-1620.
19. Cabral, HJ. Multiple comparisons procedures. Circulation 2008; 117: 698-701.
20. Harrell, F. Regression modeling strategies with applications to linear models, logistic regression, and survival analysis. New York: Springer. 2001: 74-85.
21. Anttila, V, Christou, H, Hagino, I, et al. Cerebral endothelial nitric oxide synthase expression is reduced after very-low-flow bypass. Ann Thorac Surg 2006; 81: 2202-2206.
22. Su, EJ, Fredriksson, L, Geyer, M, et al. Activation of PDGF-CC by tissue plasminogen activator impairs blood-brain barrier integrity during ischemic stroke. Nat Med 2008; 14: 731-737.
23. Miller, SP, McQuillen, PS, Hamrick, S, et al. Abnormal brain development in newborns with congenital heart disease. N Engl J Med 2007; 357: 1928-1938.
24. Mouton, R, Finch, D, Davies, I, et al. Effect of aprotinin on renal dysfunction in patients undergoing on-pump and off-pump cardiac surgery: a retrospective observational study. Lancet 2008; 371: 475-482.
25. Furnary, AP, Wu, Y, Hiratzka, LF, et al. Aprotinin does not increase the risk of renal failure in cardiac surgery patients. Circulation 2007; 116: I127-I133.