Aprotinin: Effects on Blood Loss and Fresh Frozen Plasma Requirement in Cardiac Operations

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. MJIRI, Vol. 20, No.3, 119-121, 2006.