Korean J Anesthesiol.  2000 Oct;39(4):508-515. 10.4097/kjae.2000.39.4.508.

The Influence of High- and Low-Dose Aprotinin on Thromboelastography in Coronary Artery Bypass Grafting Surgery

• Han JS
• Jung SM
• Lee SY
• Yoo ES
• Suh CK
• Min SK

• KMID: 2031610
• DOI: http://doi.org/10.4097/kjae.2000.39.4.508

Abstract

BACKGROUND: The protease inhibitor aprotinin reduces blood loss and homologous blood usage after a cardiac operation. The aim of the present study was to investigate the effect of low- and high-dose aprotinin on thromboelastography (TEG) variables and to examine the relationship between the clinical effect of aprotinin and the TEG variables in coronary artery bypass grafting surgery (CABG).
METHODS
Twenty-three patients scheduled for an elective CABG were randomly assigned to receive either high does (group H, n = 12) or low does (group L, n = 11) aprotinin. TEG variables, and a coagulation profile test at baseline and arrival in ICU were performed. Amount of blood loss, homologous blood transfusion and heparin requirements were measured.
RESULTS
In group L, there were significant increases in r time and k time and significant decreases in MA and alpha angle after aprotinin administration. In group H, just k time after aprotinin administration was significantly increased compared with baseline data. There were no significant differences in amount of blood loss and allogenic blood transfusions between the two groups. There was not a significant correlation between TEG variables and amount of blood loss in both groups. Interestingly a siginificant negative correlation between the length of cardiopulmonary bypass and MA was noted in group H (r = -0.63; P < 0.05).
CONCLUSIONS
In CABG patients, aprotinin preserves platelet function more significantly in the high-dose aprotinin group. In addition, TEG variables indicated a later clot formation in the low dose aprotinin group.

Keyword

Monitoring: thromboelastography; Pharmacology: aprotinin; high-and low-dose; Surgery: coronary artery bypass grafting

MeSH Terms

Aprotinin*
Blood Platelets
Blood Transfusion
Cardiopulmonary Bypass
Coronary Artery Bypass*
Coronary Vessels*
Heparin
Humans
Protease Inhibitors
Thrombelastography*
Aprotinin
Heparin
Protease Inhibitors