The risks associated with aprotinin use: a retrospective study of cardiac cases in Nova Scotia

Riddell, Robert E. G.; Buth, Karen J.; Sullivan, John A.

doi:10.1007/s12630-012-9806-5

Cited by 3 publications

(2 citation statements)

References 32 publications

(50 reference statements)

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“…Two small prospective RCTs and 2 retrospective studies performed after these meta-analyses in 2012 did not clarify the safety profile of aprotinin. [101][102][103][104] The authors of this guideline were not anticipating the extensiveness of the new data on the safety of aprotinin and did not select renal injury in any of the PICO questions. We thus cannot comment on data pertaining to those outcomes.…”

Section: Informed Consent and Preoperative Interventionsmentioning

confidence: 99%

STS/SCA/AmSECT/SABM Update to the Clinical Practice Guidelines on Patient Blood Management

Tibi

McClure

Huang

et al. 2021

The Annals of Thoracic Surgery

117

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O wing to the constantly evolving nature of the medical literature, The Society of Thoracic Surgeons (STS) clinical practice guidelines periodically undergo evaluation and updating. A multidisciplinary panel of experts was convened by STS, which includes members of the Society of Cardiovascular Anesthesiologists (SCA), the American Society of ExtraCorporeal Technology (AmSECT), and the Society for the Advancement of Blood Management (SABM), to review the latest data on patient blood management and to update the 2011 Update to The Society of Thoracic Surgeons and the Society of Cardiovascular Anesthesiologists Blood Conservation Clinical Practice Guidelines.

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Section: Informed Consent and Preoperative Interventionsmentioning

confidence: 99%

STS/SCA/AmSECT/SABM Update to the Clinical Practice Guidelines on Patient Blood Management

Tibi

McClure

Huang

et al. 2021

The Annals of Thoracic Surgery

117

View full text Add to dashboard Cite

show abstract

“…Two small prospective RCTs and two retrospective studies performed after these meta-analyses in 2012 did not clarify the safety profile of aprotinin (101)(102)(103)(104).…”

Section: Continuing Research On Aprotinin Vs Placebo and Vs Lysine An...mentioning

confidence: 99%

STS/SCA/AmSECT/SABM Update to the Clinical Practice Guidelines on Patient Blood Management

Tibi,

McClure,

Huang

et al. 2021

J Extra Corpor Technol

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InterventionACC/AHA Class and Level Preoperative InterventionsPreoperative identification of high-risk patients should be performed, and all available preoperative and perioperative measures of blood conservation should be undertaken in this group as they account for most blood products transfused.Class I, Level A Assessment of anemia and determination of its etiology is appropriate in all patients undergoing cardiac surgery, and it is reasonable to treat with intravenous iron preparations if time permits.Class IIA, Level B-RIn patients undergoing cardiac operations, it is reasonable to implement standardized transfusion protocols to reduce transfusion burden.Class IIA, Level B-RIn patients who have 1) preoperative anemia, 2) refuse blood transfusion, 3) or are deemed high risk for postoperative anemia, it is reasonable to administer preoperative ESAs and iron supplementation several days before cardiac operations to increase red cell mass.Class IIA Level B-R Minimization of phlebotomy by reduced volume and frequency of blood sampling is a reasonable means of blood conservation.Class IIA, Level B-NR Preoperative treatment of asymptomatic anemia and thrombocytopenia with transfusion is of uncertain benefit. Class III: No benefit, Level B-NR Preoperative antiplatelet management To reduce bleeding in patients requiring elective cardiac surgery, ticagrelor should be withdrawn preoperatively for a minimum of 3 days, clopidogrel for 5 days, and prasugrel for 7 days. Class I, Level B-NRIt is reasonable to discontinue low-intensity antiplatelet drugs (e.g., aspirin) only in purely elective patients without ACS before operation with the expectation that blood transfusion will be reduced.Class IIA, Level A Laboratory and/or POC measurement of antiplatelet drug effect in patients having received recent DAPT can be useful to assess bleeding risk or to guide timing of surgery.Class IIA, Level B-RThe addition of a P2Y12 inhibitor to aspirin therapy, if indicated, in the immediate postoperative care of CABG patients before ensuring surgical hemostasis may increase bleeding and the need for surgical reexploration and is not recommended until the risk of bleeding has abated.Class III: No benefit, Level C-LD Preoperative anticoagulantsIn patients in need of emergent cardiac surgery with recent ingestion of a nonvitamin K oral anticoagulant (NOAC) or laboratory evidence of a NOAC effect, administration of the reversal antidote specific to that NOAC is recommended (i.e., administer idarucizumab for dabigatran at appropriate dose or administer andexanet-a for either apixaban or rivaroxaban at an appropriate dose).Class IIA, Level C-LD If the antidote for the specified NOAC is not available, prothrombin concentrate is recommended, recognizing that the effective response may be variable.Class IIA, Level C-LD Pharmacologic agentsUse of synthetic antifibrinolytic agents such as EACA or TXA reduces blood loss and blood transfusion during cardiac procedures and is indicated for blood conservation. Class I, Level ATXA reduces bleeding and t...

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STS/SCA/AmSECT/SABM Update to the Clinical Practice Guidelines on Patient Blood Management

Tibi

McClure

Huang

et al. 2021

Journal of Cardiothoracic and Vascular Anesthesia

131

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The risks associated with aprotinin use: a retrospective study of cardiac cases in Nova Scotia

Cited by 3 publications

References 32 publications

STS/SCA/AmSECT/SABM Update to the Clinical Practice Guidelines on Patient Blood Management

STS/SCA/AmSECT/SABM Update to the Clinical Practice Guidelines on Patient Blood Management

STS/SCA/AmSECT/SABM Update to the Clinical Practice Guidelines on Patient Blood Management

STS/SCA/AmSECT/SABM Update to the Clinical Practice Guidelines on Patient Blood Management

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