Efficacy of a high-dose aprotinin regimen for reducing transfusion requirements and inflammatory responses in adult cardiac surgery.

Author(s): Jeong DS, Kim KH, Kim CY, Kim JS

Affiliation(s): Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Chongno-gu, Seoul, Korea.

Publication date & source: 2008-09, J Int Med Res., 36(5):1039-48.

Publication type: Randomized Controlled Trial

This study evaluated and compared the risks and effects to the inflammatory response of low- and high-dose aprotinin regimens. Between January and June 2006, patients scheduled for cardiac surgery using cardiopulmonary bypass were enrolled and randomly allocated to either low- (n = 15) or high-dose (n = 13) aprotinin groups. The incidences of mortality and adverse events were comparable in both groups. Post-operative creatinine levels and blood loss were not significantly different between the two groups. With the exception of platelets, the counts of transfused allogenic blood products were not significantly different between the groups. Interleukin (IL)-6, IL-10, soluble tumour necrosis factor II receptor, and interferon-gamma levels increased in both groups compared with baseline, but no significant intergroup differences were detected. In conclusion, high- and low-dose aprotinin had similar effects in the reduction of mediastinal bleeding and attenuation of systemic inflammatory responses, and high-dose aprotinin therapy could be used without any increased adverse effects.