Comparison of epsilon aminocaproic acid and low-dose aprotinin in cardiopulmonary bypass: efficiency, safety and cost  Michael J Ray, PhD, Mark F O’Brien 

Slides:



Advertisements
Similar presentations
The effect of cardiotomy suction on the brain injury marker S100β after cardiopulmonary bypass  Russell E Anderson, MD, PhD, Lars-Olof Hansson, MD, PhD,
Advertisements

Time course of cranial ultrasound abnormalities after arterial switch operation in neonates  Matthias Sigler, MD, Jaime F Vazquez-Jimenez, MD, Ralph G.
Cytokine release and neutrophil activation are not prevented by heparin-coated circuits and aprotinin administration  Jean-Olivier Defraigne, MD, PhD,
Contemporary Bloodletting in Cardiac Surgical Care
Warfarin therapy does not increase bleeding in patients undergoing heart transplantation  Cullen D Morris, MD, J.David Vega, MD, Jerrold H Levy, MD, Nancy.
Implementation of a comprehensive blood conservation program can reduce blood use in a community cardiac surgery program  Steve Xydas, MD, Christopher.
Association of Perioperative Fluid Balance and Adverse Surgical Outcomes in Esophageal Cancer and Esophagogastric Junction Cancer  Shenhai Wei, MD, PhD,
Treatment of a persistent postoperative chylothorax with somatostatin
Reduced postoperative blood loss and transfusion requirement after beating-heart coronary operations: A prospective randomized study  Raimondo Ascione,
Jacek M. Karski, MDa, Sally J
Rewarming Rate During Cardiopulmonary Bypass Is Associated With Release of Glial Fibrillary Acidic Protein  Daijiro Hori, MD, Allen D. Everett, MD, Jennifer.
Randomized Comparison Between Normothermic and Hypothermic Cardiopulmonary Bypass in Pediatric Open-Heart Surgery  Massimo Caputo, MD, Simon Bays, Chris.
Cerebrospinal Fluid Markers of Brain Injury, Inflammation, and Blood-Brain Barrier Dysfunction in Cardiac Surgery  Björn Reinsfelt, MD, PhD, Sven-Erik.
Prospective, Randomized, Double-Blind Study of High-Dose Aprotinin in Pediatric Cardiac Operations  Michael J Davies, FRCS, Alison Allen, BScHons, Henry.
James L Zellner, MD, Scott B Kribbs, BS, B
Bashir M Matata, PhD, Andrzej W Sosnowski, MD, Manuel Galiñanes 
Intraoperative Hemoglobin Levels and Transfusion Independently Predict Stroke After Cardiac Operations  Zainab S. Bahrainwala, BS, Maura A. Grega, RN,
Aprotinin and Dipyridamole for the Safe Reduction of Postoperative Blood Loss  Gideon Cohen, Joan Ivanov, Richard D Weisel, Vivek Rao, Molly K Mohabeer,
Leukocyte depletion during cardiac operation: a new approach through the venous bypass circuit  Y.John Gu, MD, PhD, A.J de Vries, MD, Paulien Vos, Piet.
Metabolic and Hemodynamic Effects of High-Dose Insulin Treatment in Aortic Valve and Coronary Surgery  Juha K. Koskenkari, MD, Päivi K. Kaukoranta, MD,
Emergency Coronary Artery Bypass Grafting Can Be Performed Safely Without Cardiopulmonary Bypass in Selected Patients  Faraz Kerendi, MD, John D. Puskas,
Coagulofibrinolysis during heparin-coated cardiopulmonary bypass with reduced heparinization  Hiroshi Kumano, MD, PhD, Shigefumi Suehiro, MD, PhD, Koji.
Simvastatin Increases Neutrophil Apoptosis and Reduces Inflammatory Reaction After Coronary Surgery  Massimo Chello, MD, Amedeo Anselmi, MD, Cristiano.
How safe is the port access technique in minimally invasive coronary artery bypass grafting?  Selami Dogan, MD, Kai Graubitz, MD, Tayfun Aybek, MD, Mohammad.
Aprotinin in pediatric cardiac operations: a benefit in complex malformations and with high-dose regimen only  Thierry P Carrel, MD, Mike Schwanda, MD,
Susanne Lison, MD, Michael Spannagl, MD, PhD, Wulf Dietrich, MD, PhD 
Comparison of bovine and porcine heparin in heparin antibody formation after cardiac surgery  John L Francis, PhD, George J Palmer, MD, Rebecca Moroose,
Use of Recombinant Activated Factor VII Concentrate to Control Postoperative Hemorrhage in Complex Cardiovascular Surgery  Lyndsey J. Bowman, Walter E.
Comparative effects of propofol versus fentanyl on cerebral oxygenation state during normothermic cardiopulmonary bypass and postoperative cognitive dysfunction 
Risks and Predictors of Blood Transfusion in Pediatric Patients Undergoing Open Heart Operations  Andrea Székely, MD, PhD, Zsuzsanna Cserép, MD, Erzsébet.
One-stage coronary and abdominal aortic operation with or without cardiopulmonary bypass: early and midterm follow-up  Raimondo Ascione, MD, Gabriele.
Hannu J Penttilä, MD, Martti V
Hannu J Penttilä, MD, Martti V
Coronary surgery without cardiotomy suction and autotransfusion reduces the postoperative systemic inflammatory response  Martin Westerberg, MD, Anders.
Fibrinogen concentrate reduces intraoperative bleeding when used as first-line hemostatic therapy during major aortic replacement surgery: Results from.
Early or late fresh frozen plasma administration in newborns and small infants undergoing cardiac surgery: the APPEAR randomized trial  P. Bianchi, M.
Administration of recombinant activated factor VII in the intensive care unit after complex cardiovascular surgery: Clinical and economic outcomes  Walter.
Michel Carrier, MD, Michel Pellerin, MD, Louis P Perrault, MD, PhD, B
Russel Hirsch, Catherine L. Dent, Mary K. Wood, Charles B
Red Blood Cell Transfusion Is Associated With Troponin Release After Elective Off- Pump Coronary Artery Bypass Surgery  Fausto Biancari, MD, PhD, Eeva-Maija.
Anticoagulation with bivalirudin during cardiopulmonary bypass in cardiac surgery  Julio C Vasquez, MD, Anna Vichiendilokkul, PharmD, Syed Mahmood, MD,
Individualized heparin and protamine management in infants and children undergoing cardiac operations  Massimiliano Codispoti, MD, Christopher A Ludlam,
Abciximab and bleeding during coronary surgery: results from the EPILOG and EPISTENT trials∗  A.Michael Lincoff, MD, LeRoy A LeNarz, MD, George J Despotis,
Mudassir I Dar, Timothy Gillott, Franco Ciulli, MD, Graham J Cooper 
Inhibitory effect of milrinone on cytokine production after cardiopulmonary bypass  Nobuhiko Hayashida, MD, PhD, Hiroshi Tomoeda, MD, Takeshi Oda, MD,
No benefit of reduced heparinization in thoracic aortic operation with heparin-coated bypass circuits  Christian Olsson, MD, Agneta Siegbahn, MD, PhD,
Inflammatory Mediators in Adults Undergoing Cardiopulmonary Bypass: Comparison of Centrifugal and Roller Pumps  Saeed Ashraf, John Butler, Yi Tian, Dahlia.
Time course of proinflammatory and anti-inflammatory responses after cardiac operation: monocyte HLA-DR expression  Y.John Gu, MD, PhD, Willem van Oeveren,
Prothrombin complex concentrate vs fresh frozen plasma for reversal of dilutional coagulopathy in a porcine trauma model  G. Dickneite, I. Pragst  British.
Predictors of Survival After Operation Among Patients With Large Cell Neuroendocrine Carcinoma of the Lung  Florian Eichhorn, MD, Hendrik Dienemann, MD,
Michael W. A. Chu, MD, Steve R. Wilson, BS, Richard J
Use of recombinant factor VIIa as a rescue treatment for intractable bleeding following repeat aortic arch repair  Greg Stratmann, MD, PhD, Isobel A Russell,
Minimal access aortic valve replacement: effects on morbidity and resource utilization  Nicolas Doll, MD, Michael A Borger, MD, PhD, Joerg Hain, Jan Bucerius,
Aprotinin Enhances the Endogenous Release of Interleukin-10 After Cardiac Operations  Gary E Hill, Robert P Diego, Alfred H Stammers, Suzanne M Huffman,
Intermittent Warm Blood Cardioplegia Preserves Myocardial β-Adrenergic Receptor Function  Massimo Chello, Pasquale Mastroroberto, Vincenzo De Amicis,
Effect of Nitric Oxide Gas on Platelets During Open Heart Operations
Randomized Controlled Trial of Pericardial Blood Processing With a Cell-Saving Device on Neurologic Markers in Elderly Patients Undergoing Coronary Artery.
Aprotinin is Not Associated With Postoperative Renal Impairment After Primary Coronary Surgery  Gabriella Lindvall, MD, Ulrik Sartipy, MD, PhD, Torbjörn.
Postoperatively administered aprotinin or epsilon aminocaproic acid after cardiopulmonary bypass has limited benefit  Michael J Ray, PhD, Majella M Hales,
Reduced inotropic support after aprotinin therapy during pediatric cardiac operations  Carl F Wippermann, MD, Franz X Schmid, MD, Balthasar Eberle, MD,
Aprotinin in primary valve replacement and reconstruction: A multicenter, double-blind, placebo-controlled trial  Michael N. D'Ambra, MD, Cary W. Akins,
Treatment of left atrial dissection after mitral repair: internal drainage  Michele Genoni, MD, Rolf Jenni, MD, Edith R Schmid, MD, Paul R Vogt, MD, Marko.
The use of routine chest x-ray films after chest tube removal in postoperative cardiac patients  James T McCormick, DO, Michael S O’Mara, MD, Pavlos K.
Desmopressin does not reduce bleeding and transfusion requirements in congenital heart operations  William C Oliver, MD, Paula J Santrach, MD, Gordon.
Fibrinolysis-adjusted perioperative low-dose aprotinin reduces blood loss in bypass operations  Martin Misfeld, MD, Sven Dubbert, Sawas Eleftheriadis,
Neutrophil CD11b upregulation during cardiopulmonary bypass is associated with postoperative renal injury  Christine S Rinder, MD, Manuel Fontes, MD,
Influence of High- and Low-Dose Aprotinin on Activation of Hemostasis in Open Heart Operations  Wulf Dietrich, Karl Schöpf, Michael Spannagl, Marianne.
Karl A. Bocchieri, BS, CCP, S. Jacob Scheinerman, MD, L
Safety of low hematocrits during cardiopulmonary bypass
High-Dose ϵ-Aminocaproic Acid Versus Aprotinin: Antifibrinolytic Efficacy in First-Time Coronary Operations  Balthasar Eberle, Eckhard Mayer, Gerhard.
Presentation transcript:

Comparison of epsilon aminocaproic acid and low-dose aprotinin in cardiopulmonary bypass: efficiency, safety and cost  Michael J Ray, PhD, Mark F O’Brien  The Annals of Thoracic Surgery  Volume 71, Issue 3, Pages 838-843 (March 2001) DOI: 10.1016/S0003-4975(00)02229-3

Fig 1 Cumulative chest drainage for the first 24 hours postoperatively. No significant difference existed between the treatment groups. Results are expressed as the medians, the error bars represent the 25th and 75th percentiles. Due to measurements being to the nearest 50 mL, medians and ranges for both groups were often identical. (EACA = epsilon aminocaproic acid.) The Annals of Thoracic Surgery 2001 71, 838-843DOI: (10.1016/S0003-4975(00)02229-3)

Fig 2 Cumulative hemoglobin loss for the first 24 hours postoperatively. There was no significant difference between treatment groups. (EACA = epsilon aminocaproic acid.) The Annals of Thoracic Surgery 2001 71, 838-843DOI: (10.1016/S0003-4975(00)02229-3)

Fig 3 Percentage of patients requiring intraoperative and postoperative transfusion in the low-dose aprotinin and epsilon aminocaproic acid (EACA) groups. There was no significant difference between treatment groups. (FFP = fresh frozen plasma.) The Annals of Thoracic Surgery 2001 71, 838-843DOI: (10.1016/S0003-4975(00)02229-3)

Fig 4 The changes from base line levels of troponin I perioperatively. In this and subsequent figures, stage 0 = induction of anesthesia, stage 1 = 30 minutes into bypass, stage 2 = 1 hour after bypass, stage 3 = 4 hours after bypass, stage 4 = 24 hours after bypass. p values refer to the differences between the treatment groups. The Annals of Thoracic Surgery 2001 71, 838-843DOI: (10.1016/S0003-4975(00)02229-3)

Fig 5 The changes from base line levels of neuron specific enolase (NSE) during and after bypass. (EACA = epsilon aminocaproic acid.) The Annals of Thoracic Surgery 2001 71, 838-843DOI: (10.1016/S0003-4975(00)02229-3)

Fig 6 The changes from base line levels of S-100β during and after bypass. The results for the patients with no neurologic deficit are expressed as medians, the error bars representing the 25th and 75th percentiles. The other two series are the individual data points for 2 patients, 1 of whom had perioperative hemiparesis and another who had two grand mal seizures. The Annals of Thoracic Surgery 2001 71, 838-843DOI: (10.1016/S0003-4975(00)02229-3)