Abstract
Beyond those general remarks, Dr Faraoni is quite right when he critically expresses the lack of knowledge about pharmacokinetic and pharmacodynamic data resulting in questionable dosing regimens of either lysine analog causing potentially dose-dependent side effects. Up to now, the majority of trials on antifibrinolytic medications in pediatric cardiac surgery remained focused on blood loss and partially on transfused blood products [4]. However, with the ongoing use of the lysine analogs for antifibrinolytic purposes, we have to conduct comparative trials investigating not only efficacy but also safety. ‘Otherwise, we will continue to repeat the unfortunate history of aprotinin, in which large numbers of patients received a therapy that apparently was suboptimal’ [5].
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