BIOMAT Database Logo BIOMAT Database Logo

Maintenance of therapeutic plasma aprotinin levels during prolonged cardiopulmonary bypass using a large-dose regimen. 1996

E Bennett-Guerrero, and J G Sorohan, and S T Howell, and L Ayuso, and R A Cardigan, and M F Newman, and I J Mackie, and J G Reves, and M G Mythen
Department of Anesthesiology, Mount Sinai Medical Center, New York, NY 10029, USA.

Aprotinin concentrations in the range of 127-191 kallikrein inactivator units (KIU)/mL at the end of cardiopulmonary bypass (CPB) (< 2 h duration) reduce transfusion requirements. It has been suggested that prolonged CPB may require higher infusion rates which significantly increase cost. We tested the hypothesis that large-dose aprotinin maintains therapeutic plasma levels during prolonged periods of CPB (< 2 h). Aprotinin was administered as follows: 2 x 10(6) KIU upon skin incision; 0.5 x 10(6) KIU/h x 4-h infusion on initiation of CPB; and 2 x 10(6) KIU added to the CPB prime solution. Aprotinin activity was measured 1) 30 min after initiation of drug administration (Pre-CPB); 2) 30 min after initiation of CPB (CPB + 30); 3) 90 min after initiation of CPB (CPB + 90); and 4) at CPB termination (End CPB). CPB duration (mean +/- SD) was 158 +/- 51 min. Plasma aprotinin concentrations (KIU/mL, mean +/- SD) were: 234 +/- 30 at Pre-CPB; 229 +/- 35 at CPB + 30; 184 +/- 27 at CPB + 90; and 179 +/- 22 at End CPB. In all patients, aprotinin levels at the completion of CPB were in the range previously reported to be effective. The authors conclude that large-dose regimen limited to 6 x 10(6) KIU maintained therapeutic plasma aprotinin concentrations during prolonged CPB.

UI MeSH Term Description Entries
D007262 Infusions, Intravenous The long-term (minutes to hours) administration of a fluid into the vein through venipuncture, either by letting the fluid flow by gravity or by pumping it. Drip Infusions,Intravenous Drip,Intravenous Infusions,Drip Infusion,Drip, Intravenous,Infusion, Drip,Infusion, Intravenous,Infusions, Drip,Intravenous Infusion
D007387 Internal Mammary-Coronary Artery Anastomosis Direct myocardial revascularization in which the internal mammary artery is anastomosed to the right coronary artery, circumflex artery, or anterior descending coronary artery. The internal mammary artery is the most frequent choice, especially for a single graft, for coronary artery bypass surgery. Anastomosis, Internal Mammary-Coronary Artery,Coronary-Internal Mammary Artery Anastomosis,Internal Mammary Coronary Artery Anastomosis,Anastomosis, Internal Mammary Coronary Artery,Coronary Internal Mammary Artery Anastomosis
D007611 Aprotinin A single-chain polypeptide derived from bovine tissues consisting of 58 amino-acid residues. It is an inhibitor of proteolytic enzymes including CHYMOTRYPSIN; KALLIKREIN; PLASMIN; and TRYPSIN. It is used in the treatment of HEMORRHAGE associated with raised plasma concentrations of plasmin. It is also used to reduce blood loss and transfusion requirements in patients at high risk of major blood loss during and following open heart surgery with EXTRACORPOREAL CIRCULATION. (Reynolds JEF(Ed): Martindale: The Extra Pharmacopoeia (electronic version). Micromedex, Inc, Englewood, CO, 1995) BPTI, Basic Pancreatic Trypsin Inhibitor,Basic Pancreatic Trypsin Inhibitor,Bovine Kunitz Pancreatic Trypsin Inhibitor,Kallikrein-Trypsin Inactivator,Kunitz Pancreatic Trypsin Inhibitor,Trypsin Inhibitor, Basic, Pancreatic,Trypsin Inhibitor, Kunitz, Pancreatic,Antilysin,Bovine Pancreatic Trypsin Inhibitor,Contrical,Contrykal,Dilmintal,Iniprol,Kontrikal,Kontrykal,Pulmin,Traskolan,Trasylol,Zymofren,Inactivator, Kallikrein-Trypsin,Kallikrein Trypsin Inactivator
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D001803 Blood Transfusion The introduction of whole blood or blood component directly into the blood stream. (Dorland, 27th ed) Blood Transfusions,Transfusion, Blood,Transfusions, Blood
D002314 Cardioplegic Solutions Solutions which, upon administration, will temporarily arrest cardiac activity. They are used in the performance of heart surgery. Cardioplegic Solution,Solution, Cardioplegic,Solutions, Cardioplegic
D002315 Cardiopulmonary Bypass Diversion of the flow of blood from the entrance of the right atrium directly to the aorta (or femoral artery) via an oxygenator thus bypassing both the heart and lungs. Heart-Lung Bypass,Bypass, Cardiopulmonary,Bypass, Heart-Lung,Bypasses, Cardiopulmonary,Bypasses, Heart-Lung,Cardiopulmonary Bypasses,Heart Lung Bypass,Heart-Lung Bypasses
D003365 Costs and Cost Analysis Absolute, comparative, or differential costs pertaining to services, institutions, resources, etc., or the analysis and study of these costs. Affordability,Analysis, Cost,Cost,Cost Analysis,Cost Comparison,Cost Measures,Cost-Minimization Analysis,Costs and Cost Analyses,Costs, Cost Analysis,Pricing,Affordabilities,Analyses, Cost,Analyses, Cost-Minimization,Analysis, Cost-Minimization,Comparison, Cost,Comparisons, Cost,Cost Analyses,Cost Comparisons,Cost Measure,Cost Minimization Analysis,Cost, Cost Analysis,Cost-Minimization Analyses,Costs,Measure, Cost,Measures, Cost
D004334 Drug Administration Schedule Time schedule for administration of a drug in order to achieve optimum effectiveness and convenience. Administration Schedule, Drug,Administration Schedules, Drug,Drug Administration Schedules,Schedule, Drug Administration,Schedules, Drug Administration

Related Publications

E Bennett-Guerrero, and J G Sorohan, and S T Howell, and L Ayuso, and R A Cardigan, and M F Newman, and I J Mackie, and J G Reves, and M G Mythen
Effect of aprotinin on plasma fibronectin levels during cardiopulmonary bypass.
January 1997, The Annals of thoracic surgery,
E Bennett-Guerrero, and J G Sorohan, and S T Howell, and L Ayuso, and R A Cardigan, and M F Newman, and I J Mackie, and J G Reves, and M G Mythen
Changes in the kallikrein-kinin-system after different dose regimen of aprotinin during cardiopulmonary bypass operation.
January 1989, Advances in experimental medicine and biology,
E Bennett-Guerrero, and J G Sorohan, and S T Howell, and L Ayuso, and R A Cardigan, and M F Newman, and I J Mackie, and J G Reves, and M G Mythen
Economic evaluation of high-dose and low-dose aprotinin therapy during cardiopulmonary bypass.
September 1999, The Annals of thoracic surgery,
E Bennett-Guerrero, and J G Sorohan, and S T Howell, and L Ayuso, and R A Cardigan, and M F Newman, and I J Mackie, and J G Reves, and M G Mythen
Effect of aprotinin on plasma fibronectin levels in patients undergoing cardiopulmonary bypass.
August 1992, Journal of cardiothoracic and vascular anesthesia,
E Bennett-Guerrero, and J G Sorohan, and S T Howell, and L Ayuso, and R A Cardigan, and M F Newman, and I J Mackie, and J G Reves, and M G Mythen
Plasma fibronectin levels during cardiopulmonary bypass.
November 1990, Journal of applied physiology (Bethesda, Md. : 1985),
E Bennett-Guerrero, and J G Sorohan, and S T Howell, and L Ayuso, and R A Cardigan, and M F Newman, and I J Mackie, and J G Reves, and M G Mythen
Increased anticoagulation during cardiopulmonary bypass by aprotinin.
October 1990, The Journal of thoracic and cardiovascular surgery,
E Bennett-Guerrero, and J G Sorohan, and S T Howell, and L Ayuso, and R A Cardigan, and M F Newman, and I J Mackie, and J G Reves, and M G Mythen
Increased anticoagulation during cardiopulmonary bypass by aprotinin.
November 1991, The Journal of thoracic and cardiovascular surgery,
E Bennett-Guerrero, and J G Sorohan, and S T Howell, and L Ayuso, and R A Cardigan, and M F Newman, and I J Mackie, and J G Reves, and M G Mythen
Platelet preservation during cardiopulmonary bypass with aprotinin.
January 1989, European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery,
E Bennett-Guerrero, and J G Sorohan, and S T Howell, and L Ayuso, and R A Cardigan, and M F Newman, and I J Mackie, and J G Reves, and M G Mythen
Platelet preservation by aprotinin during cardiopulmonary bypass.
March 1988, Lancet (London, England),
E Bennett-Guerrero, and J G Sorohan, and S T Howell, and L Ayuso, and R A Cardigan, and M F Newman, and I J Mackie, and J G Reves, and M G Mythen
Aprotinin and heparin monitoring during cardiopulmonary bypass.
November 1992, Circulation,
Copied contents to your clipboard!