Aprotinin in deep hypothermic circulatory arrest

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Aprotinin in deep hypothermic circulatory arrest Craig R Smith, MD, Talia B Spanier, MD The Annals of Thoracic Surgery Volume 68, Issue 1, Pages 278-286 (July 1999) DOI: 10.1016/S0003-4975(99)00518-4

Fig 1 Aprotinin and CPB. Aprotinin interferes with the activation of coagulation during CPB at several steps, including inhibition of contact activation through blockade of kallekrein, blockade of platelet activation, and its direct antifibrinolytic effect. tPA = tissue plasminogen activator; C3a, C5a: complement fragments C3a and C5a. The Annals of Thoracic Surgery 1999 68, 278-286DOI: (10.1016/S0003-4975(99)00518-4)

Fig 2 Aprotinin and hypothermia. Aprotinin interferes with many of the procoagulant effects of hypothermia through its inhibitory effects on kallekrein and fibrinolysis and through its protective effects on platelets. tPA = tissue plasminogen activator; C3a, C5a: complement fragments C3a and C5a. The Annals of Thoracic Surgery 1999 68, 278-286DOI: (10.1016/S0003-4975(99)00518-4)

Fig 3 Anticoagulant effects of Protein C. Protein C is one of the important natural anticoagulants that promotes fibrinolysis through activation of tPA when activated in the presence if thrombin, and inhibits clotting through its inactivation of factors Va and VIIIa. tPA = tissue plasminogen activator. The Annals of Thoracic Surgery 1999 68, 278-286DOI: (10.1016/S0003-4975(99)00518-4)