Use of Aprotinin in the Control of Bleeding During Cardiopulmonary Bypass Surgery: Current Status

Excessive bleeding is one of the major complica tions of cardiac surgery with cardiopulmonary bypass (CPB). This complication is related to the operation and the defects in hemostasis induced by extracorporeal circulation. The system atic effects of CPB are called whole body inflammatory reac tion....

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Bibliographic Details
Published inClinical and applied thrombosis/hemostasis Vol. 4; no. 1; pp. 2 - 6
Main Author Roque, Pifarrè
Format Journal Article
LanguageEnglish
Published Thousand Oaks, CA SAGE Publications 01.01.1998
SAGE PUBLICATIONS, INC
Subjects
Anticoagulants
Heart surgery
Cardiopulmonary bypass
Key Words: Anticoagulation
Aprotinin
Heparin
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Summary:Excessive bleeding is one of the major complica tions of cardiac surgery with cardiopulmonary bypass (CPB). This complication is related to the operation and the defects in hemostasis induced by extracorporeal circulation. The system atic effects of CPB are called whole body inflammatory reac tion. Heparin, platelet dysfunctions, and fibrinolysis are the major causes of bleeding problems associated with CPB. Dif ferent pharmacological approaches have been used to reduce bleeding and the need for blood transfusions in patients under going cardiac surgery. The most effective is aprotinin, a serum protease inhibitor that is an antifibrinolytic with a platelet- preserving action. It inhibits the activation of the intrinsic co agulation system. Aprotinin therapy effectively reduces blood loss and donor blood requirements. According to most reports, it does not increase the risk of acute myocardial infarction, renal dysfunction, and mortality.
ISSN:1076-0296
1938-2723
DOI:10.1177/107602969800400103