Aprotinin Versus Placebo in Major Orthopedic Surgery: A Randomized, Double-Blinded, Dose-Ranging Study

Abstract

Large doses of aprotinin decrease blood loss and transfusion amount in major orthopedic surgery.

Tranexamic acid reduces the need for allogenic red blood cell transfusions in patients undergoing total hip replacement

“…Changes in Hb level indicate that blood losses of patients undergoing TKR and THR could be as much as 1000 mL over those measured by weighing sponges plus intra-and postoperative drainage. 20 These hidden blood losses might explain the apparent discrepancy between the lack of difference in measured blood losses and the reduction of patients requiring a red blood cell transfusion with TA.…”

The current place of aprotinin in the management of bleeding

“…This has been shown in randomised placebo controlled studies in cardiac [5], major orthopaedic [6] and hepatic transplantation surgery [7]. Aprotinin has received a licence in Europe only for cardiac surgery procedures, and in those patients receiving aspirin before surgery, there is a consistent reduction in transfusion compared with no effect in the one study investigating TXA [8].…”

Acquired Coagulopathies: Current Approaches to Differential Diagnosis and Intensive Care in the Context of Evidence-Based Medicine

“…Интраоперационное ис пользование апротинина на 33-67% снижает потерю крови и на 42-88% потребность в гемотрансфузиях [42][43][44] (уровень доказательств -1); на основании этого рекомендуется обяза тельное применение препаратов апротинина при прогнозиро вании значительного интраоперационного кровотечения. Ле чебные дозы апротинина -трасилол сначала в/в болюсно 200-500 тыс.…”