Reduction in blood loss and blood use after cardiopulmonary bypass with high dose aprotinin (Trasylol)

Bidstrup, Benjamin P.; Royston, David; Sapsford, Ralph N.; Taylor, Kenneth M.

doi:10.1016/s0022-5223(19)34573-8

Cited by 500 publications

(75 citation statements)

References 31 publications

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“…26 Antifibrinolytic agents like aprotonin and epsilon aminocaproic acid are used to inhibit the fibrinolytic activity associated with cardiopulmonary bypass surgical procedures. 27,28,36 The prophylactic treatment of patients subjected to cardiopulmonary bypass surgery with the antifibrinolytic agent epsilon aminocaproic acid has been shown to reduce bleeding in these patients. 36 A study from our laboratory has reported the safety and therapeutic effectiveness of the reinfused nonwashed mediastinal shed blood after open-heart surgery.…”

Section: Discussionmentioning

confidence: 99%

“…37 The aprotonin used to treat the plasma produced a level of 150 KIU/mL, which was three times higher than the amount of aprotinin used to treat patients subjected to cardiopulmonary bypass surgical procedures to inhibit the fibrinolytic activity in these patients. 27,28,38 The bleeding times were significantly increased in baboons receiving plasma treated with urokinase or plasma treated with urokinase-aprotonin compared to bleeding times in baboons receiving nontreated plasma. The increased bleeding times correlated with increases in FDP and D-dimer levels, and with decreases in plasma fibrinogen levels during the 4-hour posttransfusion period.…”

Section: Discussionmentioning

confidence: 99%

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Hemostatic Defect in Baboons Autotransfused Treated Plasma to Simulate Shed Blood

et al. 2006

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Hemostatic Defect in Baboons Autotransfused Treated Plasma to Simulate Shed Blood

et al. 2006

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“…81,82 Treatment of plasma to inhibit the fibrinolytic activity of urokinase with the antifibrinolytic agent aprotonin simulated the quality of shed blood collected during and after cardiopulmonary bypass surgical procedures. 83,84 The volume of treated plasma infused equivalent to 15 percent of the blood volume simulated the volume of plasma reinfused with nonwashed shed blood that was not associated with a bleeding disorder in patients. [85][86][87] Baboons were used in this study because previous studies have documented the similarities between baboon and human PLTs and clotting proteins.…”

Section: Studies Performed To Assess the Hemostatic Defect In Baboonsmentioning

confidence: 99%

The survival and function of baboon red blood cells, platelets, and plasma proteins: a review of the experience from 1972 to 2002 at the Naval Blood Research Laboratory, Boston, Massachusetts

Valeri¹,

Ragno²

2006

Transfusion

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The studies reported in this monograph were performed between 1972 and 2002 when it was possible to study healthy male and female baboons. A colony of baboons was maintained for 30 years without any adverse events observed in these baboons in the numerous studies that were performed. These protocols were reviewed and approved by the institutional animal care and use committees (IACUC) at the sites where the studies were performed and by the veterinarian services of the U.S. Navy's Bureau of Medicine and Surgery, the Office of Naval Research, and the Department of Defense. The physiology of red blood cells (RBCs), platelets (PLTs), and plasma proteins in the baboon was investigated together with the viability and function of preserved RBCs, PLTs, and plasma proteins. These studies in the baboon could not have been performed in normal volunteers and patients. The data obtained have provided critical information to explain the clinical observations reported in normal volunteers and patients after transfusion of fresh and preserved blood products. These studies were supported by the U.S. Navy's Bureau of Medicine and Surgery and the Office of Naval Research. In addition, the support of the late Congressman J. Joseph Moakley from Massachusetts is acknowledged because without his support many of these studies could not have been performed. The authors acknowledge the contributions of the numerous research collaborators identified in the 52 peer-reviewed publications that cite other funding agencies that supported the research that is reported, the editorial assistance of Ms Cynthia Ann Valeri, and the assistance of Ms Deborah Tattersall who prepared the figures and tables reported in this publication.

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“…All of these factors may contribute to the potential usefulness of aprotinin in abciximabtreated patients. [66][67][68] Aprotinin and the lysine analogs have demonstrated efficacy in reducing blood loss and transfusion requirements in patients undergoing CABG surgery; however, their role in abciximabtreated patients requires further study.…”

Section: Options For Minimizing Bleeding Riskmentioning

confidence: 99%

Management of Antiplatelet Therapy for Minimization of Bleeding Risk Before Cardiac Surgery

2006

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Antiplatelet therapy is commonly administered for primary and secondary prevention of stroke, recurrent angina, myocardial infarction, and death in patients with cardiovascular disorders. It also is associated with an increased risk of bleeding. We describe the management of antiplatelet therapy in patients undergoing coronary artery bypass graft surgery. In addition, we provide basic information about the mechanisms of action by which the most common antiplatelet agents inhibit platelet function. This information is integrated with results from pharmacologic studies and clinical trials. Determining the net effect in patients undergoing coronary artery bypass graft surgery requires knowledge about the pharmacokinetics, pharmacodynamics, and clinical efficacy of each drug, and an estimation of the absolute thrombotic versus hemorrhagic risk for each patient.

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Reduction in blood loss and blood use after cardiopulmonary bypass with high dose aprotinin (Trasylol)

Cited by 500 publications

References 31 publications

Hemostatic Defect in Baboons Autotransfused Treated Plasma to Simulate Shed Blood

Hemostatic Defect in Baboons Autotransfused Treated Plasma to Simulate Shed Blood

The survival and function of baboon red blood cells, platelets, and plasma proteins: a review of the experience from 1972 to 2002 at the Naval Blood Research Laboratory, Boston, Massachusetts

Management of Antiplatelet Therapy for Minimization of Bleeding Risk Before Cardiac Surgery

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