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Eur J Cardiothorac Surg 2001;20:38-41
© 2001 Elsevier Science NL

Reduced blood loss by aprotinin in thoracic surgical operations associated with high risk of bleeding.

A placebo-controlled, randomized phase IV study

^a Department of Thoracic Surgery, Center of Pneumology and Thoracic Surgery, Schillerhoehe Hospital, Gerlingen, Germany
^b Department of Anesthesiology and Intensive Medicine, Schillerhoehe Hospital, Gerlingen, Germany

Received 16 March 2001; received in revised form 12 April 2001; accepted 14 April 2001.

Corresponding author. Tel.: +49-7156-203-2259; fax: +49-7156-203-2008
e-mail: kyriss{at}klinik-schillerhoehe.de

Objective: Although the blood-saving effect of aprotinin has been well documented in cardiac surgery and lung transplantation, its use in lung surgery has received less attention. We present our experience with the intraoperative application of aprotinin in lung resections with a predicted high risk of bleeding. Methods: Thirty-eight patients undergoing major thoracic surgical procedures were randomized into treatment and placebo groups. The treatment group (n=18) received a bolus of 2x10⁶ kallikrein inhibitor units (KIU) of aprotinin followed by 5x10⁵ KIU/h during surgery. The placebo group (n=20) received an isotonic saline infusion instead. Results: There was no significant difference between the groups concerning diagnosis, co-morbidity, age, sex, height, and weight. The mean intraoperative blood loss in the treatment group was significantly reduced (342 vs. 808 ml, P<0024), postoperative blood loss was also reduced (623 vs. 1282 ml, P<0.0007) and the need for blood transfusion was less (14 vs. 60, n.s.). No severe side effects of aprotinin were registered. Re-thoracotomy was necessary in two patients of the placebo group because of postoperative bleeding. Conclusion: Aprotinin reduces the perioperative blood loss and the need for blood transfusion in thoracic surgical procedures in patients with an increased risk of bleeding.

Key Words: Aprotinin • Intraoperative blood loss • Thoracic surgery • Pulmonary resection

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