[Effects of low doses of aprotinin in heart surgery].

OBJECTIVES

To study the effect of aprotinin (Trasylol) administration on bleeding after surgery and on the need for blood transfusion in patients undergoing cardiopulmonary bypass with extracorporeal circulation (ECC).

PATIENTS AND METHODS

One hundred ten patients were studied prospectively, divided into two groups. In the aprotinin group (n = 80), the ECC pump was primed with 140 mg of aprotinin and followed with continuous intravenous perfusion at 70 mg/h from the start of ECC until the patient left the operating theater. The control group (n = 30) served as reference. The parameters compared were the hematocrit, number of platelets, prothrombin time and activated coagulation time, as well as drainage of blood through thoracic tubes at 3 and 24 h after surgery and the amount of blood transfused both during and after the procedure.

RESULTS

Blood loss was significantly lower in the aprotinin group as compared with the control group, both at 3 h (227 +/- 193 vs 380 +/- 169 ml; p < 0.05) and at 24 h (422 +/- 322 ml vs 736 +/- 342 ml; p < 0.05) after surgery. There was also a significant decrease in blood requirements in the aprotinin group (550 +/- 450 ml vs 872 +/- 747 ml; p < 0.05). There were no differences between the two groups for the other parameters studied.

CONCLUSIONS

Administration of aprotinin at low doses during surgery in patients undergoing cardiac surgery with ECC significantly reduces postoperative bleeding and the amount of blood transfused.