개심술시 Aprotinin 의 용량이 술후 출혈 및 수혈량에 미치는 영향

• Published in: Korean journal of anesthesiology Vol. 32; no. 2; pp. 244 - 251
• Main Authors: 홍용우, Yong Woo Hong, 곽영란, Young Lan Kwak, 방서옥, Sou Ouk Bang, 유은숙, Eun Sook Yoo, 이춘수, Choon Soo Lee, 정금희, Keum Hee Chung
• Format: Journal Article
• Language: Korean
• Published: 대한마취통증의학회(구 대한마취과학회) 28.02.1997
• Subjects: aprotinin; cardiac. Pharmacology; Surgery
• ISSN: 2005-6419; 2005-7563

Background : 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. Methods : 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. Results : 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. Conclusion : 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. (Korean J Anesthesiol 1997; 32: 244∼251)