Continuous Small-Dose Aprotinin Controls Fibrinolysis During Orthotopic Liver Transplantation
| Autor: | R. L. Vera, Randy J. Marcel, T. H. Swygert, J. C. Arnold, Michael A. E. Ramsay, H A T Hein, W. C. Stegall, C. T. Suit, M. B. O'donnell, Charles W. Whitten |
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| Rok vydání: | 1996 |
| Předmět: |
Antifibrinolytic
medicine.drug_class medicine.medical_treatment Liver transplantation Drug Administration Schedule Hemostatics Placebos Aprotinin Double-Blind Method Fibrinolysis Humans Medicine Anesthesia Prospective Studies Infusions Intravenous Saline Prothrombin time Dose-Response Relationship Drug medicine.diagnostic_test business.industry Liver Transplantation Transplantation Anesthesiology and Pain Medicine Liver Prothrombin Time Partial Thromboplastin Time business hormones hormone substitutes and hormone antagonists Partial thromboplastin time medicine.drug |
| Zdroj: | Anesthesia & Analgesia. 82:1122-1125 |
| ISSN: | 0003-2999 |
| DOI: | 10.1097/00000539-199606000-00004 |
| Popis: | Large doses of aprotinin (1,000,000-2,000,000 kallikrein inhibitor units [KIU] initial dose and a 500,000 KIU/h infusion) have been used during orthotopic liver transplantation (OLT) to reduce the incidence and severity of fibrinolysis. This double-blinded study was designed to investigate whether a small-dose infusion of aprotinin (200,000 KIU/h) would control fibrinolysis. A controlled study was undertaken to compare small-dose aprotinin with a placebo in patients undergoing OLT with veno-venous bypass. Forty-four patients were randomized either to the aprotinin group (n = 21), which received an intravenous infusion of 200,000 KIU/h without an initial dose, or to a control group (n = 23), which received normal saline. Coagulation variables, thrombelastograms, and postoperative blood drainage were measured. Blood levels of fibrin degradation products (FDP) were significantly higher in the control group (95% > 20 micrograms/mL) at the end of surgery compared to the aprotinin group (53% > 20 micrograms/mL, P < 0.01). The transfusion of cryoprecipitate units was more in the control group versus the aprotinin (12.6 +/- 12.8 vs 5.7 +/- 7.5; P < 0.04), as was the number of fresh frozen plasma units (6.6 +/- 3.5 vs 3.6 +/- 6.1; P < 0.05). We conclude that an infusion of a small dose of aprotinin can safely control fibrinolysis during liver transplantation with a concomitant reduction in transfusion of blood products. |
| Databáze: | OpenAIRE |
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