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Korean Journal of Anesthesiology 1994;27(4):373-380.
DOI: https://doi.org/10.4097/kjae.1994.27.4.373   
Effect of high-dose aprotinin on blood loss and need for blood transfusion after repeat open heart surgery .
Yong Woo Hong, Jin Kyung Kim, Chung Hyun Park
Department of Anesthesiology, Yonsei Cardiovascular Center, Yonsei University College of Medicine, Seoul, Korea.
The effect of the proteinase-inhibitor aprotinin on blood loss and homologous blood requirement in repeat mitral valve replacement whieh has a tendency of postoperative bleeding and increases requirement of homologous blood transfusion was investigated. In a prospective study, 15 adult patients were treated with high-dose aprotinin (according to body weight) who were assigned to aprotinin group while 12 patients without aprotinin administration served as the controls. The average blood loss 24 hours postoperatively in the aprotinin group was 357.3+/-44.0 mL compared with 1606.7+/-214.2 mL in the control group (P<0.05). Total homologous blood requirements were also significantly less in the aprotinin group (0.93+/-0.4 units), compared with the control group (5.42+/-0.6 units) (P<0.05). All patients in the control group and 47% in the aprotinin group received homologous blood transfusion. This study shows the efficacy of high-dose aprotinin therapy in reducing posto-perative blood loss and homologous blood requirement in the complicated repeat cardiac surgery. In addition reduction of intraoperative blood loss may lead to reduction of operative length. Therefore, the routine use of aprotinin can be recommended for the patients undergoing repeat cardiac surgery.
Key Words: Aprotinin; Blood transfusion; Repeat open heart surgery


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