NDLI: The influence of aprotinin and tranexamic acid on platelet function and postoperative blood loss in cardiac surgery.

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The influence of aprotinin and tranexamic acid on platelet function and postoperative blood loss in cardiac surgery.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Mengistu, Andinet M. Röhm, Kerstin D. Boldt, Joachim Mayer, Jochen Suttner, Stefan W. Piper, Swen N.
Description	Country affiliation: Germany Author Affiliation: Mengistu AM ( Department of Anesthesiology and Intensive Care Medicine, Klinikum Ludwigshafen, Bremserstrasse 79, D-67063 Ludwigshafen, Germany. a.mengistu@gmx.de)
Abstract	BACKGROUND: Antifibrinolytic drugs including aprotinin and tranexamic acid are currently used in cardiac surgery to reduce postoperative bleeding and transfusion requirements, and may have different effects on platelets. We therefore evaluated platelet function after cardiopulmonary bypass (CPB) and cardiac surgery to determine the effect of either aprotinin or tranexamic acid. METHODS: In a prospective, randomized study, 50 patients scheduled for elective cardiac surgery with CPB were evaluated. Patients received high-dose aprotinin (n = 25) or tranexamic acid (n = 25) as antifibrinolytic drugs. Coagulation and platelet function were assessed preoperatively, after CPB, 3 and 24 h after surgery using modified thrombelastography and whole blood aggregometry. RESULTS: Impaired coagulation after CPB occurred in both groups compared with preoperative data (P < 0.01). In contrast to modified thrombelastography, thrombin receptor-mediated aggregometry after CPB was significantly decreased only in those patients receiving tranexamic acid until the end of the study period in comparison to the aprotinin group (P < 0.05). Aprotinin-treated patients showed significantly less chest tube drainage (575 mL +/- 228 vs 1033 mL +/- 647, P < 0.05) and need for postoperative transfusion requirements (P < 0.01) compared with the tranexamic acid group. CONCLUSIONS: Platelet function measured by whole blood aggregometry is better preserved by aprotinin than tranexamic acid and may be responsible for producing less bleeding within the first 24 h after CPB.
File Format	HTM / HTML
ISSN	00032999
Issue Number	2
Volume Number	107
e-ISSN	15267598
Journal	Anesthesia & Analgesia
Language	English
Publisher	Lippincott Williams & Wilkins
Publisher Date	2008-08-01
Publisher Place	United States
Access Restriction	One Nation One Subscription (ONOS)
Subject Keyword	Discipline Anesthesiology Antifibrinolytic Agents Therapeutic Use Aprotinin Coronary Artery Bypass Hemostatics Postoperative Hemorrhage Prevention & Control Serine Proteinase Inhibitors Tranexamic Acid Aged Blood Coagulation Drug Effects Blood Transfusion Cardiopulmonary Bypass Female Humans Male Plasma Substitutes Platelet Aggregation Platelet Function Tests Thrombelastography Journal Article Randomized Controlled Trial Retracted Publication
Content Type	Text
Resource Type	Article
Subject	Anesthesiology and Pain Medicine

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