aprotinin: effects on blood loss and fresh frozen plasma requirement in cardiac operations

abstract background: aprotinin has been used increasingly to reduce postoperative blood loss in open-heart operations due to the potentialities for complications and high cost, it would seem reasonable to use aprotinin more selectively in small doses in the prime solution of the pump. methods: we prospectively studied the effect of preoperative low dose aprotinin [2 million units (230mg)] on blood loss and transfusion requirements in patients undergoing cardiopulmonary bypass. one-hundred and fifty patients were randomly assigned to two groups: prophylactic low dose aprotinin (group 1) and a non-medicated control group (group 2). the two groups were comparable in all demographic and operative variables. results: postoperative chest tube drainage was significantly decreased in the aprotinin group compared with that in the control group (372.73 ml in group 1 and 482.2 ml in group 2, p< 0.05). no significant difference was seen between the two groups in regard to transfusion requirement (p>0.05). the use of fresh frozen plasma (ffp) was significantly less in group 1 than in group 2 (469.87 ml versus 680.69 ml, p< 0.05). conclusion: prophylactic use of low-dose aprotinin immediately before cardiopulmonary bypass reduced the need for transfusion of blood & fresh frozen plasma (ffp) during the post operative period.