Influence of High- and Low-Dose Aprotinin on Activation of Hemostasis in Open Heart Operations Wulf Dietrich, Karl Schöpf, Michael Spannagl, Marianne.

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Presentation transcript:

Influence of High- and Low-Dose Aprotinin on Activation of Hemostasis in Open Heart Operations Wulf Dietrich, Karl Schöpf, Michael Spannagl, Marianne Jochum, Siegmund L Braun, Hans Meisner The Annals of Thoracic Surgery Volume 65, Issue 1, Pages 70-77 (January 1998) DOI: 10.1016/S0003-4975(97)01123-5

Fig. 1 Aprotinin plasma concentration. At all time points, significant differences between the groups in aprotinin plasma concentrations were demonstrated. The aprotinin concentration of 200 KIU/mL that is necessary for the inhibition of kallikrein was not reached in all patients of group H. The concentrations found in group L were far below this value. (CPB = cardiopulmonary bypass; Op = operation; SD = standard deviation.) The Annals of Thoracic Surgery 1998 65, 70-77DOI: (10.1016/S0003-4975(97)01123-5)

Fig. 2 Activation of hemostasis. Intraoperative course of indicators of thrombin generation (F1+2 prothrombin fragments) and fibrinolytic activation (d-dimers). The levels of d-dimers were reduced significantly in the high-dose aprotinin group. (CPB = cardiopulmonary bypass; Op = operation; preop = before operation; SD = standard deviation.) The Annals of Thoracic Surgery 1998 65, 70-77DOI: (10.1016/S0003-4975(97)01123-5)

Fig. 3 Perioperative course of celite and kaolin activated clotting time (ACT). Aprotinin causes a prolongation of the ACT when celite is used as the activator. The celite ACT was prolonged significantly in group H compared with group L. There were no differences in the kaolin ACT. (CPB = cardiopulmonary bypass; Op = operation; preop = before operation; SD = standard deviation.) The Annals of Thoracic Surgery 1998 65, 70-77DOI: (10.1016/S0003-4975(97)01123-5)

Fig. 4 Blood loss. Box plot of postoperative blood loss. The top of the box represents the 75th percentile, the line in the middle the median, and the bottom the 25th percentile. Blood loss was reduced significantly in patients of group H compared with those of group L. (po = after operation.) The Annals of Thoracic Surgery 1998 65, 70-77DOI: (10.1016/S0003-4975(97)01123-5)