Replacement of aprotinin by ε-aminocaproic acid in infants undergoing cardiac surgery: Consequences for blood loss and outcome

British Journal of Anaesthesia

Volumn 110, Issue 4, 2013, Pages 615-621

  Martin, K ^a   Gertler, R ^a   Macguill, M ^a   Mayr, N P ^a   Hapfelmeier, A ^b   Horer J ^a   Vogt, M ^a   Tassani, P ^a   Wiesner, G ^a  

^a TECHNICAL UNIVERSITY OF MUNICH   (Germany)

^b TECHNICAL UNIVERSITY OF MUNICH   (Germany)

Author keywords

blood, transfusion; paediatric cardiac anaesthesia; surgery, cardiovascular

Indexed keywords

AMINOCAPROIC ACID; APROTININ;

ARTICLE; BLOOD TRANSFUSION; BLOOD VESSEL INJURY; CARDIOPULMONARY BYPASS; CHEST TUBE; CHILD; CONTROLLED STUDY; FEMALE; HEART SURGERY; HUMAN; INFANT; KIDNEY INJURY; MAJOR CLINICAL STUDY; MALE; MEDICAL RECORD REVIEW; MORTALITY; NEUROLOGICAL COMPLICATION; OUTCOME ASSESSMENT; PEDIATRIC SURGERY; POSTOPERATIVE COMPLICATION; POSTOPERATIVE HEMORRHAGE; PRESCHOOL CHILD; PRIORITY JOURNAL; REOPERATION; RETROSPECTIVE STUDY;

EID: 84875638067     PISSN: 00070912     EISSN: 14716771     Source Type: Journal    
DOI: 10.1093/bja/aes430     Document Type: Article

References (28)

1. Eaton MP. Antifibrinolytic therapy in surgery for congenital heart disease. Anesth Analg 2008; 106: 1087-100
2. Andrew M, Paes B, Milner R, et al. Development of the human coagulation system in the healthy premature infant. Blood 1988; 72: 1651-7
3. Andrew M, Paes B, Milner R, et al. Development of the human coagulation system in the full-term infant. Blood 1987; 70: 165-72
4. Kern FH, Morana NJ, Sears JJ, Hickey PR. Coagulation defects in neonates during cardiopulmonary bypass. Ann Thorac Surg 1992; 54: 541-6
5. Gans H, Krivit W. Problems in hemostasis during open heart surgery. III. Epsilon amino caproic acid as an inhibitor of plasminogen activator activity. Ann Surg 1962; 155: 268-76
6. Williams GD, Bratton SL, Nielsen NJ, Ramamoorthy C. Fibrinolysis in pediatric patients undergoing cardiopulmonary bypass. J Cardiothorac Vasc Anesth 1998; 12: 633-8
7. Ferraris VA, Ferraris SP, Saha SP, et al. Perioperative blood transfusion and blood conservation in cardiac surgery: the Society of Thoracic Surgeons and The Society of Cardiovascular Anesthesiologists clinical practice guideline. Ann Thorac Surg 2007; 83: S27-86
8. Williams GD, Bratton SL, Riley EC, Ramamoorthy C. Association between age and blood loss in children undergoing open heart operations. Ann Thorac Surg 1998; 66: 870-5; discussion 5-6
9. Eisses MJ, Chandler WL. Cardiopulmonary bypass parameters and hemostatic response to cardiopulmonary bypass in infants versus children. J Cardiothorac Vasc Anesth 2008; 22: 53-9
10. Martin K, Gertler R, Liermann H, et al. Switch from aprotinin to epsilon-aminocaproic acid: impact on blood loss, transfusion, and clinical outcome in neonates undergoing cardiac surgery. Br J Anaesth 2011; 107: 934-9
11. Ririe DG, James RL, O'Brien JJ, et al. The pharmacokinetics of epsilon-aminocaproic acid in children undergoing surgical repair of congenital heart defects. Anesth Analg 2002; 94: 44-9, table of contents
12. Martin K, Breuer T, Gertler R, et al. Tranexamic acid versus epsilon-aminocaproic acid: efficacy and safety in paediatric cardiac surgery. Eur J Cardiothorac Surg 2011; 39: 892-7
13. Lacour-Gayet F, Clarke D, Jacobs J, et al. The Aristotle score: a complexity-adjusted method to evaluate surgical results. Eur J Cardiothorac Surg 2004; 25: 911-24
14. Akcan-Arikan A, Zappitelli M, Loftis LL,Washburn KK, Jefferson LS, Goldstein SL. Modified RIFLE criteria in critically ill children with acute kidney injury. Kidney Int 2007; 71: 1028-35
15. Schwartz GJ, Brion LP, Spitzer A. The use of plasma creatinine concentration for estimating glomerular filtration rate in infants, children, and adolescents. Pediatr Clin North Am 1987; 34: 571-90
16. Guzzetta NA, Evans FM, Rosenberg ES, et al. The impact of aprotinin on postoperative renal dysfunction in neonates undergoing cardiopulmonary bypass: a retrospective analysis. Anesth Analg 2009; 108: 448-55
17. Chauhan S, Kumar BA, Rao BH, et al. Efficacy of aprotinin, epsilon aminocaproic acid, or combination in cyanotic heart disease. Ann Thorac Surg 2000; 70: 1308-12
18. Pasquali SK, Li JS, He X, et al. Comparative analysis of antifibrinolytic medications in pediatric heart surgery. J Thorac Cardiovasc Surg 2012; 143: 550-7
19. Dorman BH, Stroud RE, Wyckoff MM, et al. Differential effects of epsilon-aminocaproic acid and aprotinin on matrix metalloproteinase release in patients following cardiopulmonary bypass. J Cardiovasc Pharmacol 2008; 51: 418-23
20. Greilich PE, Brouse CF, Whitten CW, Chi L, Dimaio JM, Jessen ME. Antifibrinolytic therapy during cardiopulmonary bypass reduces proinflammatory cytokine levels: a randomized, double-blind, placebo-controlled study of epsilon-aminocaproic acid and aprotinin. J Thorac Cardiovasc Surg 2003; 126: 1498-503
21. Greilich PE, Okada K, Latham P, Kumar RR, Jessen ME. Aprotinin but not epsilon-aminocaproic acid decreases interleukin-10 after cardiac surgery with extracorporeal circulation: randomized, double-blind, placebo-controlled study in patients receiving aprotinin and epsilon-aminocaproic acid. Circulation 2001; 104: I265-9
22. Ranucci M, Corno A, Pavesi M, et al. Renal effects of low dose aprotinin in pediatric cardiac surgery. Minerva Anestesiol 1994; 60: 361-6
23. Leyvi G, Nelson O, Yedlin A, et al. A comparison of the effect of aprotinin and epsilon-aminocaproic acid on renal function in children undergoing cardiac surgery. J Cardiothorac Vasc Anesth 2011; 25: 402-6
24. Szekely A, Sapi E, Breuer T, et al. Aprotinin and renal dysfunction after pediatric cardiac surgery. Paediatr Anaesth 2008; 18: 151-9
25. Aperia A, Broberger O, Elinder G, Herin P, Zetterstrom R. Postnatal development of renal function in pre-term and full-term infants. Acta Paediatr Scand 1981; 70: 183-7
26. Petaja J, Peltola K. Venous thrombosis in pediatric cardiac surgery. J Cardiothorac Vasc Anesth 1997; 11: 889-94
27. Martin K, Wiesner G, Breuer T, Lange R, Tassani P. The risks of aprotinin and tranexamic acid in cardiac surgery: a one-year follow-up of 1188 consecutive patients. Anesth Analg 2008; 107: 1783-90
28. Breuer T, Martin K, Wilhelm M, et al. The blood sparing effect and the safety of aprotinin compared to tranexamic acid in paediatric cardiac surgery. Eur J Cardiothorac Surg 2009; 35: 167-71