Aprotinina preserva plaquetas em crianças com cardiopatia congênita acianogênica operadas com circulação extracorpórea?

Abstract

Aprotinina preserva plaquetas em crianças com cardiopatia congênita acianogênica operadas com circulação extracorpórea?Does aprotinin preserve platelets in children with acyanogenic congenital heart disease undergone surgery with cardiopulmonary bypass? Abstract Objective: Evaluation of the hemostatic and platelets effects in children with acyanogenic congenital heart disease undergone on-pump surgery who received aprotinin.Methods: A prospective randomized study was performed on children aged 30 days to 4 years who had undergone correction of acyanogenic congenital heart disease using cardiopulmonary bypass (CPB) and were divided into two groups: Control (n=9) and Aprotinin (n=10). In the Aprotinin Group the drug was administered before and during CPB and the hemostatic dysfunction was analyzed by clinical and biochemical markers. Differences were considered to be significant when P<0.05.Results: The groups were similar regarding demographic and intraoperative variables, except for a greater hemodilution in the Aprotinin Group. The drug presented no benefit regarding time of mechanical pulmonary ventilation, stay in the postoperative intensive care unit and hospital, or regarding the use of inotropic drugs and renal function. Platelet concentration was preserved with the use of Aprotinin, whereas thrombocytopenia occurred in the Control Group since the initiation of CPB. Blood loss 5.

Prophylactic Use of Antifibrinolytics During Pediatric Cardiac Surgery With Cardiopulmonary Bypass on Postoperative Bleeding and Transfusion: A Systematic Review and Meta-Analysis

“…The initial literature search resulted in 1,008 studies, of which 221 were used for full-text review. Sixty-eight articles, with a total of 28,735 patients, met inclusion criteria and were used in the analysis (3, 6, 7, 18–82). The PRISMA diagram describing the screening of studies is presented in Figure 1.…”

Efficacy and safety of aprotinin in paediatric cardiac surgery

“…22,[30][31][32][33][34] Only 10 out of 32 studies were randomised controlled trials. 11,14,15,20,26,33,[35][36][37][38] Two observational studies were prospective studies with sample sizes varying from 199 18 to 657 16 children. Twenty studies were retrospective and had sample sizes varying from 56 21 to 30 372 29 children.…”

“…11,14,15,20,26,33,[35][36][37][38] Of the two prospective observational studies, one left the choice for aprotinin to the discretion of the attending anaesthesiologist 16 and the other used a timed-based allocation method, 18 causing a high risk for selection bias. Discrete factors, such as physician bias regarding patient selection, 10,12,[21][22][23]25,31,39,42 choice of aprotinin use, 34,41 heterogeneous control group (TXA or no drug) with two different CPB circuits, 10 lack of standardised transfusion protocols 12,13,16,21,25,29,30,32,40,43 and lack of full blinding of surgical personnel and outcome assessors, 11,15,16,18,20,36 may account for some of the heterogeneity and conflicting effects observed in the observational and retrospective studies. Two studies 15,20 only applied blinding during surgery, resulting in an important risk of detection bias.…”

Os perfusionistas Brasileiros e o ajuste do rolete arterial: comparação entre a calibração estática e dinâmica

“…The professionals involved in surgery have sought alternatives that might reduce the use of cardiopulmonary bypass (CPB), as well as the use of new techniques that minimize trauma to the blood cells by the use of CPB [5][6][7][8][9].…”