Plasma aprotinin concentrations during cardiac surgery: full- versus half-dose regimens.
| Autor: | Beath SM; Departments of Cardiovascular Anesthesiology and Anesthesiology, Mayo Graduate School of Medicine, Rochester, MN 55905, USA., Nuttall GA, Fass DN, Oliver WC Jr, Ereth MH, Oyen LJ |
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| Jazyk: | angličtina |
| Zdroj: | Anesthesia and analgesia [Anesth Analg] 2000 Aug; Vol. 91 (2), pp. 257-64. |
| DOI: | 10.1097/00000539-200008000-00002 |
| Abstrakt: | Unlabelled: Aprotinin is an effective but expensive drug used during cardiac surgery to reduce blood loss and transfusion requirements. Currently, aprotinin is administered to adults according to a fixed protocol regardless of the patient's weight. The purpose of this study was to determine aprotinin levels in patients receiving full- and half-dose aprotinin regimens by a simple functional aprotinin assay and to design a more individualized aprotinin dosage regimen for cardiac surgical patients. The mean plasma aprotinin concentration peaked 5 min after the initiation of cardiopulmonary bypass (full 401 +/- 92 KIU/mL, half 226 +/- 56 KIU/mL). The mean plasma aprotinin concentration after 60 min on cardiopulmonary bypass was less (full 236 +/- 81 KIU/mL, half 160 +/- 63 KIU/mL). There was large variation in the aprotinin concentration among patients. A statistically significant correlation was found between aprotinin concentration and patient weight (r(2) = 0.67, P < 0.05). Implications: The current dosing schedule for aprotinin results in a large variation in aprotinin plasma concentrations among patients and a large variation within each patient over time. We combined the information provided by our study with that of a previous pharmacokinetic study to develop a potentially improved, weight-based, dosing regime for aprotinin. |
| Databáze: | MEDLINE |
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