Korean J Anesthesiol.  2000 Feb;38(2):370-373. 10.4097/kjae.2000.38.2.370.

Intraoperative Anaphylactoid Reaction Due to Aprotinin during Pediatric Open Heart Surgery

• Sim JY
• Park JY
• Kweon EH
• Choi IC

• KMID: 1936364
• DOI: http://doi.org/10.4097/kjae.2000.38.2.370

Abstract

Aprotinin is a serine protease inhibitor that improves the hemostatic function and modulates the anti-inflammatory responses. Recently, aprotinin has been widely used in various surgical procedures including open heart surgery. One of the complications of aprotinin is anaphylactic reaction and the incidence increases with re-exposure. We experienced a case of anaphylactic reaction in a 5-year-old female during open heart surgery. After cardiopulmonary bypass weaning, during aprotinin i.v. infusion for reducing blood loss, sudden hypotension and bradycardia occurred. After re-institution of CPB, the patient recovered. In the post-operative review of the chart and patient, we found that this patient had been exposed to aprotinin 20 days ago. In conclusion, we recommend some preventable methods for anaphylaxis of aprotinin; aprotinin should be used after a skin test or i.v. infusion test and used by mixing with CPB priming solution.

Keyword

Complications: anaphylactoid reaction; Pharmacology: aprotinin; Surgery: open heart surgery

MeSH Terms

Anaphylaxis
Aprotinin*
Bradycardia
Cardiopulmonary Bypass
Child, Preschool
Female
Heart*
Humans
Hypotension
Incidence
Serine Proteases
Skin Tests
Thoracic Surgery*
Weaning
Aprotinin
Serine Proteases