A prospective randomized controlled study to assess the efficacy of aprotinin in paediatric cardiac surgery

Dr Ramkumar Dhanasekaran, Dr. Ashok Kumar
2014 IOSR Journal of Dental and Medical Sciences  
Children undergoing cardiopulmonary bypass (CBP) for repair of congenital heart defects are at substantial risk for excessive bleeding due to hemodilution, hypothermia, systemic inflammatory response causing platelet dysfunction and increased fibrinolysis, contributing greatly to morbidity and mortality. The antiplasmin and antikallikrein action of aprotinin provides a significant anti-fibrinolytic and anti-inflammatory effect. Hence, it was used to decrease bleeding and the need for
more » ... need for transfusion. Methods: Forty patients of either sex scheduled for surgical closure of either Ventricular Septal Defects (VSD) or Atrial Septal Defects (ASD) were randomly allocated into two groups. Group (A) patients received 20000 KIU/kg (Kallikrien Inhibitor Units) of aprotinin bolus after induction, 20000 KIU/kg in prime and maintenance infusion dose of 10000 KIU/kg/min till skin closure. Group (P) patients received equal volume of Ringer Lactate solution. The time interval from protamine administration to skin closure, the volume of blood loss in chest drain for initial 24 hours and the volume of blood transfused postoperatively were studied. Conclusion: For the parameters studied, reduction in the frequency and amount of blood transfusion, and reduced operative closure times remains as important benefits of aprotinin.
doi:10.9790/0853-131121621 fatcat:yy7xutmh2jgodpo57l2havwg2y