The Topical Use of Aprotinin in Cardiac Surgery with Cardiopulmonary Bypass

Abstract：Objective To investigate the effects of the topical use of aprotinin an the basisof comprrehensive blood conservations in cardiopulmonary bypass ( CPB). Methods In a prospectiveclinical trial, 20 patients were randomly divided into 2 groups. Control group: placebo was used topical-ly. Aprotinin group: aprotinin was poured into the pericardial cavity before closure of the sternotomy.Before and 24 h after surgery, hemoglobin ( Hb), hematocrit ( Hct), bleeding time (BT), clottingtime (CT) and prothrombin time (PT) were measured. Meanwhile, amounts of the mediastinaldrainage and the hemoglobin loss were observed at 0, 2, 6 and 24 h after operation. The samples fromthe mediastinal drainage were also collected to measure D-Dimer (D-D), tissue type plasminogen activa-tor (t-PA) activity, plasminogen activator inhibitor ( PAI) activity and protein C (PC). ResultsIn Aprotinin group, D-D, t-PA activity and PC were significantly reduced, compared with those in Con-trol group ( P ＜ 0. 05, P＜0. 05, P＜0. 01). On the contrary, PAI activity was significantly in-creased, compared with that in Control group. Amounts of the mediastinal drainage and the hemoglobinloss were decreased by 43% and 52%, compared with those in Control group. Conclusion Ourresults suggest that the topical use of aprotinin can have better effects an the basis of comprehensive mod-erate blood conservation.