Reduced inotropic support after aprotinin therapy during pediatric cardiac operations

Wippermann, C.-F.; Schmid, Franz X.; Eberle, Balthasar; Huth, R.; Kampmann, Christoph; Schranz, Dietmar; Oelert, H

doi:10.1016/s0003-4975(98)00974-6

Cited by 33 publications

(16 citation statements)

References 18 publications

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“…On the other hand, cTnI, the absence of myocardial-protecting effect of the Aprotinin opposed either the previous reports, indicatives of benefits [7,8] as well as other, in which it was detrimental [9]. The same applies to the dosages of CKMB that did not differ from those of the Control Group, with similar serum profile to those of other studies involving children [24].…”

Section: Discussionmentioning

confidence: 50%

“…and expressed by less inotropic support in the first 48h after ECC, was shown by Wippermann et al [7], in 1999. On the other hand, Broche et al [8], in 2002, reported a decrease in the production of free radicals and systemic oxidative stress, by aprotinin, in children under mechanical cardiorespiratory support, with secondary reduction of the low debt cardiac syndrome and arrhythmias, whilst Mössinger et al [2], in 2003, showed that the drug reduces pulmonary and haemostatic dysfunction levels.…”

Section: Descritores: Procedimentos Cirúrgicos Cardiovasculares Circmentioning

confidence: 73%

“…The similarity of the groups regarding the duration, associations and dose of inotropics in the first 48h after ECC, a well as the times of mechanical pulmonary ventilation and stay in PICU, implicates that the aprotinin did not influence favorably in these clinical variables. This does not relate to the studies in which the aprotinin reduced the use of inotropics [7], the incidence of low debit syndrome and arrhythmias [8], stay in PICU, hospital internment and duration of mechanical ventilation [2,4]. In the Aprotinin Group, however, there was a tendency to higher incidence of organic dysfunctions, either cardiovascular (60% vs. 33.3%) or respiratory (40% vs. 22.2%), although with no statistically significant difference.…”

Section: Discussionmentioning

confidence: 84%

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Aprotinina não influencia troponina I, NTproBNP e função renal em crianças operadas com circulação extracorpórea

Ferreira¹,

Vicente²,

Évora³

et al. 2009

Rev Bras Cir Cardiovasc

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Aprotinina não influencia troponina I, NTproBNP e função renal em crianças operadas com circulação extracorpóreaHigh-dose aprotinin does not affect troponin I, N-Terminal pro-B-type natriuretic peptid and renal function in children submitted to surgical correction with extracorporeal circulation Abstract Objective: Evaluate if the use of hemostatic high-dose aprotinin seems influence to myocardial, renal and metabolic functions in children submitted to surgical correction with extracorporeal circulation (ECC). Material and Methods A prospective randomized study was conducted on children aged 30 days to 4 years submitted to correction of acyanogenic congenital heart disease with ECC and divided into two groups: Control (n=9) and Aprotinin (n=10). In the Aprotinin Group the drug was administered before and during ECC and the myocardial and multiorgan dysfunctions were analyzed on the basis of 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 had no benefit regarding time of mechanical pulmonary ventilation, permanence in the pediatric postoperative intensive care unit (ICU) and length of hospitalization, or regarding the use of inotropic drugs and renal function. The partial arterial oxygen pressure/inspired oxygen fraction ratio (PaO 2 /FiO 2 ) was significantly reduced 24h after surgery in the Control Group. Blood loss was similar for both groups. Cardiac troponin I (cTnI), creatine kinase MB fraction (CKMB), serum glutamic-oxaloacetic transaminase (SGOT) and the aminoterminal fraction of natriuretic peptide type B (NT-proBNP) did not differ significantly between groups.7. PhD; of HC FMRP-USP. 8. Master; HC FMRP-USP.Work performed at

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Section: Discussionmentioning

confidence: 50%

Section: Descritores: Procedimentos Cirúrgicos Cardiovasculares Circmentioning

confidence: 73%

Section: Discussionmentioning

confidence: 84%

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Aprotinina não influencia troponina I, NTproBNP e função renal em crianças operadas com circulação extracorpórea

Ferreira¹,

Vicente²,

Évora³

et al. 2009

Rev Bras Cir Cardiovasc

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“…A aprotinina é uma protease sérica não específica que inibe a coagulação, a fibrinólise e a ativação do complemento. Ainda não há consenso sobre o benefício de seu uso em cirurgia cardíaca pediátrica, embora haja na literatura relatos favorá-veis [64][65][66][67][68] . A possível formação de trombina, levando a disfunção renal e instabilidade hemodinâmica, é um efeito colateral descrito com esta droga.…”

Section: O Uso De Corticóides E Antifibrinolíticosunclassified

“…Aprotinin is a nonspecific serum protease which inhibits coagulation, fibrinolysis and complement activation. There is still no consensus on its benefit for pediatric cardiac surgery, although there are favorable results in the literature [64][65][66][67][68] . The possible formation of thrombin leading to renal dysfunction and hemodynamic instability is a side effect described with this drug.…”

Section: Steroids and Antifibrinolyticsmentioning

confidence: 99%