Abstract
BACKGROUND: The use of aprotinin, a antifibrinolytic agent, has been shown to decrease damaging effects on cardiopulmonary bypass in fibrinolytic system, which may improve hemostasis. OBJECTIVE: To study the effect of low dose aprotinin in patients undergoing extracorporeal circulation. METHOD: Seventeen patients, underwent cardiopulmonary bypass to mitral valve replacement, was ramdomized in two groups: I (control) ¾ 9 patients received placebo after anesthesia induction and each hour in the priming; II (aprotinin) ¾ 8 patients received after anesthesia induction 30,000 KIU/kg and 7.500 KIU/kg each hour in the priming during the perfusion. The blood loss was observed through the first 24 hours postoperatively. Arterial blood samples were taken after anesthesia induction and after administration of protamina in order to analyse: prothrombin activity (PA), partial thomboplastin time (PTT), thrombin time (TT), euglobulin lysis time (ELT) and to measure levels of fibrinogen (F), d-dimer (dD) and antithrombin III (ATIII). RESULTS: Mean postoperative bleeding at the 24th hours was 690.67±377 in the control group and 248,.75±105 in the aprotinin group (p=0.0017). The results taken from the blood samples were shown above. CONCLUSION: It follows that aprotinin, in low dose, was able to inhibit fibrinolysis and reduced bleeding after cardiopulmonary bypass.
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