Swart M J, Gordon P C, Hayse-Gregson P B, Dyer R A, Swanepoel A L, Buckels N J, Schall R, Odell J A
Department of Cardiothoracic Surgery, Groote Schuur Hospital, Cape Town, South Africa.
Anaesth Intensive Care. 1994 Oct;22(5):529-33. doi: 10.1177/0310057X9402200505.
Fifty patients undergoing primary coronary artery bypass surgery and 50 patients undergoing valve surgery received either high-dose aprotinin (2 million units loading dose, 2 million units added to the CPB prime, and 500,000 units/hr maintenance infusion) or placebo. Mean postoperative blood loss in the first six hours was reduced from 321 ml in the placebo group to 172 ml in the aprotinin group (95% confidence interval (CI) for difference = 95 to 189 ml). Seven patients in the placebo group and 16 patients in the aprotinin group did not require transfusion with homologous blood. This study adds to the growing body of evidence that the administration of high-dose aprotinin reduces blood loss and blood transfusion requirements associated with primary cardiac surgery.
50例行初次冠状动脉搭桥手术的患者和50例行瓣膜手术的患者，分别接受高剂量抑肽酶（200万单位负荷剂量，200万单位加入体外循环预充液中，50万单位/小时持续输注）或安慰剂治疗。术后前6小时的平均失血量从安慰剂组的321毫升降至抑肽酶组的172毫升（差异的95%置信区间（CI）为95至189毫升）。安慰剂组有7例患者、抑肽酶组有16例患者无需输注同源血。这项研究进一步补充了越来越多的证据，表明高剂量抑肽酶的应用可减少与初次心脏手术相关的失血和输血需求。
