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Korean Journal of Anesthesiology 1997;32(2):244-251.
DOI: https://doi.org/10.4097/kjae.1997.32.2.244   
Effects of Three Different Regimens of Aprotinin Dosage on Blood Loss During Open Heart Surgery.
Yong Woo Hong, Young Lan Kwak, Sou Ouk Bang, Eun Sook Yoo, Chun Soo Lee, Keum Hee Chung
1Department of Anesthesiology, Yonsei Cardiovascular Center and research institute, Yonsei University College of Medicine, Seoul, Korea.
2Department of Anesthesiology, Kang Nam General Hospital, Seoul, Korea.
High dose of aprotinin has been known to reduce the requirement for homologous transfusion and the loss of blood during cardiac operation. The aim of this study was to investigate an effective minimal dose of aprotinin.
With IRB approval 61 patients undergoing cardiac operation were divided into four groups. Group I was control (n=15). Group II(high dose aprotinin, n=16) received an infusion of 24,000 KIU/kg of aprotinin followed by continous infusion of 6,000 KIU/kg per hour until the end of operation. A bolus of 24,000 KIU/kg was added to pump prime solution. Group III(low dose aprotinin, n=16) received a bolus of 24,000 KIU/kg to prime solution. Group IV(minimal dose aprotinin, n=14) received a bolus of 12,000 KIU/kg to prime solution. Coagulation profiles were analysed and blood loss through chest tubes & amount of homologous transfusion was measured. Statistical analysis was performed using one-way variance analysis.
Group II demonstrated less amount of blood loss than group I with statistical significance. Blood loss in group III was reduced about 20% but the reduction was not statistically significant. Group IV could not reduce the blood loss.
This study shows the efficacy of high and low dose(not statistically significant) aprotinin infusion during cardiac surgery in postoperative blood loss. Use of aprotinin less than low dose regimen may not be effective in reducing the blood loss and amount of homologous transfusion in cardiac operation.
Key Words: Surgery cardiac; Pharmacology aprotinin


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