| Intraoperative Anaphylactoid Reaction Due to Aprotinin during Pediatric Open Heart Surgery. |
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Ji Yeon Sim, Jong Yeon Park, Eun Ha Kweon, In Cheol Choi |
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Department of Anesthesiology, College of Medicine, University of Ulsan, Seoul, Korea. |
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| Abstract |
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Aprotinin is a serine protease inhibitor that improves the hemostatic function and modulates the anti-inflammatory responses. Recently, aprotinin has been widely used in various surgical procedures including open heart surgery.
One of the complications of aprotinin is anaphylactic reaction and the incidence increases with re-exposure. We experienced a case of anaphylactic reaction in a 5-year-old female during open heart surgery. After cardiopulmonary bypass weaning, during aprotinin i.v. infusion for reducing blood loss, sudden hypotension and bradycardia occurred.
After re-institution of CPB, the patient recovered. In the post-operative review of the chart and patient, we found that this patient had been exposed to aprotinin 20 days ago.
In conclusion, we recommend some preventable methods for anaphylaxis of aprotinin; aprotinin should be used after a skin test or i.v. infusion test and used by mixing with CPB priming solution. |
| Key Words:
Complications: anaphylactoid reaction; Pharmacology: aprotinin; Surgery: open heart surgery |
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