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AprotininCardiopulmonary BypassCardiopulmonary ResuscitationHemostaticsCardiac Surgical ProceduresHeart Arrest, InducedCirculatory Arrest, Deep Hypothermia InducedHypothermia, InducedAntifibrinolytic AgentsExtracorporeal CirculationCoronary Artery BypassBlood Loss, SurgicalPostoperative HemorrhageTranexamic AcidPostoperative ComplicationsHeart ArrestAminocaproic AcidSerine Proteinase InhibitorsCoronary Artery Bypass, Off-PumpIntraoperative CareOxygenatorsPostoperative PeriodTreatment OutcomeDiatomaceous EarthGastric BypassWhole Blood Coagulation TimeIntraoperative PeriodBlood TransfusionTime FactorsHeart Defects, CongenitalMonitoring, IntraoperativeProspective StudiesSternotomyHeparin AntagonistsHemodynamicsRewarmingHemostasis, SurgicalCardiovascular Surgical ProceduresSystemic Inflammatory Response SyndromeIntraoperative ComplicationsExtracorporeal Membrane OxygenationOxygenators, MembraneHemodilutionSternumHeart Valve Prosthesis ImplantationPostoperative CareRetrospective StudiesCardioplegic SolutionsHeart-Lung MachineHeparinErythrocyte TransfusionThoracic Surgical ProceduresProtaminesIntra-Aortic Balloon PumpingThoracotomyEmbolism, AirAminocaproatesReoperationConstrictionLength of StayBody TemperatureSurgical Procedures, Minimally InvasiveOxygenDouble-Blind MethodFollow-Up StudiesPerioperative CareHeart DiseasesFibrinolysisSwineRisk FactorsBlood PressurePulmonary Gas ExchangeThrombelastographyMilrinoneBlood Component TransfusionBlood CoagulationHeart MassageOxygen ConsumptionSurgical Procedures, ElectiveBlood Vessel Prosthesis ImplantationThoracic SurgeryResuscitationHospital MortalityHemofiltrationPreoperative CareHematocritAortic AneurysmDogsChest TubesMiniaturizationCardiac OutputCerebrovascular CirculationEnoximoneBlood Gas AnalysisVascular Surgical ProceduresBlood Coagulation TestsVascular PatencyAssisted CirculationBiological MarkersEchocardiography, Transesophageal

Cardiac SurgeryCABGTranexamic acidAntifibrinolyticIntraoperativeSurgeryHypothermiaSystemic inflammatory responseCORONARY ARTERYPlateletCoagulationUnderwentAnaphylacticPropensityPatientsBlood lossEffectsRiskSimilarReleaseFunctionYearsManagementHeart

Cardiac Surgery10

• These were developed in 2010 to replace the use of aprotinin during and after cardiac surgery, including surgeries with cardiopulmonary bypass which cause blood loss and hemorrhagic complications. (wikipedia.org)
• The Risk Associated with Aprotinin in Cardiac Surgery. (wikipedia.org)
• Cardiac surgery with cardiopulmonary bypass (CPB) is associated with a systemic inflammatory response syndrome (SIRS) that is known to be one of the main causes of postoperative organ dysfunction (1). (peertechzpublications.com)
• Coronary and arterial thrombosis have been reported in patients following the use of aprotinin during cardiac surgery, as well as, other types of surgery and/or disease processes. (brainkart.com)
• BACKGROUND: Cardiac surgery with cardiopulmonary bypass may result in excessive fibrinolysis and platelet (PLT) dysfunction, resulting in impaired hemostasis and excessive blood loss. (doctime.es)
• STUDY DESIGN AND METHODS: Using propensity scores, 449 patients who received aprotinin for high-transfusion-risk cardiac surgery were matched to 449 patients who received tranexamic acid from a pool of 10,870 consecutive patients who underwent cardiac surgery at a single center, 586 of whom received aprotinin and the remainder of whom received tranexamic acid. (doctime.es)
• CONCLUSIONS: Aprotinin and tranexamic acid have similar hemostatic effectiveness in high-transfusion-risk cardiac surgery. (doctime.es)
• BACKGROUND Aprotinin has been used to decrease blood loss with complicated cardiac surgery but has not been investigated in extrapleural pneumonectomy, an operation that does not use cardiopulmonary bypass. (transfusionevidencelibrary.com)
• Bivalirudin as an adjunctive anticoagulant to heparin in the treatment of heparin resistance during cardiopulmonary bypass-assisted cardiac surgery. (unboundmedicine.com)
• Background: Cardiac surgery using cardiopulmonary bypass is a complex procedure, sometimes accompanied with excessive bleeding. (5dok.org)

CABG4

• Bayer announced new guidance to physicians and health care providers regarding the use of Trasylol® (aprotinin injection) in patients at an increased risk of blood loss and blood transfusion undergoing coronary artery bypass graft (CABG) surgery with cardiopulmonary bypass (CPB). (worldpharmanews.com)
• Material and methods: In study I, coagulation factor activities were measured before and after surgery in a cohort of 57 patients undergoing first time elective coronary artery bypass grafting (CABG). (5dok.org)
• The Cardiovascular and Renal Drugs Advisory Committee and the Drug Safety and Risk Management Advisory Committee to the FDA have held a meeting to discuss the risk /benefit profile of Bayerís intravenous drug Trasylol (aprotinin), which is used in coronary artery bypass graft (CABG) surgery. (pmlive.com)
• To better understand the role of acute normovolemic hemodilution (ANH) in coronary artery bypass grafting (CABG), we compared ANH with standard intraoperative care in a retrospective cohort study. (mathewsopenaccess.com)

Tranexamic acid3

• Prophylactic use of the antifibrinolytic drugs aprotinin and tranexamic acid is thought to prevent these hemostatic defects. (doctime.es)
• Adverse events rates were comparable in the two groups, except for renal dysfunction (defined as a greater than 50% increase in creatinine concentration during the first postoperative week to >100 micromol/L in women and >110 micromol/L in men or a new requirement for dialysis support), which occurred in 24 percent (107/449) of aprotinin patients and 17 percent (75/449) of tranexamic acid patients (p = 0.01). (doctime.es)
• Antifibrinolytic agents are used to counteract excessive fibrinolysis and include tranexamic acid, epsilon aminocaproic acid, and aprotinin (Tables 1 and 2). (openanesthesia.org)

Antifibrinolytic2

• Table 1: Mechanism of action, pharmacokinetics, and side effects of antifibrinolytic agents (CPB = cardiopulmonary bypass, KIU = kallikrein-inhibiting units). (openanesthesia.org)
• Continuous localized monitoring of plasmin activity identifies differential and regional effects of the serine protease inhibitor aprotinin: relevance to antifibrinolytic therapy. (ufl.edu)

Intraoperative2

• Severe intraoperative anaphylactic reaction: aprotinin and rocuronium. (uni-bielefeld.de)
• Babin-Ebell J, Misoph M, Müllges W, Neukam K, Reese J, Elert O. Intraoperative embolus formation during cardiopulmonary bypass affects the release of S 100 B. Thorac Cardiovasc Surg 1999;47:166-169. (2medicalcare.com)

Surgery5

• Milrinone enhances systolic, but not diastolic function during coronary artery bypass grafting surgery. (umontreal.ca)
• It is able to modulate the systemic inflammatory response associated with cardiopul-monary bypass surgery, thus decreasing the risk of bleeding. (brainkart.com)
• In general, the accepted goal during cardiopulmonary bypass surgery is 400-500 sec. (unboundmedicine.com)
• Aspirin and mortality from coronary bypass surgery. (stanford.edu)
• Trasylol is currently the only drug approved by the FDA for prophylactic use to reduce perioperative blood loss and blood transfusions in patients undergoing cardiopulmonary bypasses in the course of coronary artery bypass graft surgery, who are at an increased risk for blood loss and blood transfusion. (pmlive.com)

Hypothermia2

• Because different methodologies and a number of variables (eg, platelet count and function, hypothermia, hemodilution, and certain drugs like aprotinin) may affect the ACT, the ACT test is not yet standardized. (unboundmedicine.com)
• Surgical techniques that employ hypothermia and cardiopulmonary bypass circuits have an increased propensity to activate the fibrinolytic system. (openanesthesia.org)

Systemic inflammatory response1

• Cardiopulmonary bypass (CPB) induces a systemic inflammatory response which is thought to be a significant cause of postoperative organ dysfunction and mortality. (peertechzpublications.com)

CORONARY ARTERY2

• Twenty patients undergoing coronary artery bypass grafting were included. (peertechzpublications.com)
• 1001 patients having elective coronary artery bypass from March 1991-July 1992. (bestbets.org)

Platelet1

• Koray Ak, Ergun S, Altınoz H, Uyguner ZO, Tetik S (2016) GG Polymorphism of Platelet ITGA2B Gene Increases the Magnitude of Interleukin-6 Release after Cardiopulmonary Bypass. (peertechzpublications.com)

Coagulation1

• In controlled US trials with aprotinin, an incidence between 1% and 2% was reported for the following: throm-bocytopenia, leukocytosis, coagulation disorders (including disseminated intravascular coagulation). (brainkart.com)

Underwent1

• In this prospective, randomized, placebo-controlled, double-blind trial, the authors investigated whether aprotinin decreased blood loss in patients who underwent this operation. (transfusionevidencelibrary.com)

Anaphylactic2

• We detected anti-aprotinin antibodies by an enzyme immunoassay in serum of a 33 year old man who showed anaphylactic reactions during heart transplantation under aprotinin reexposition. (uni-bielefeld.de)
• During therapeutic use with aprotinin, the following have occurred infrequently: anaphylactic or anaphylactoid reactions which can range from mild to life-threatening symptoms and may not appear until the second or third dose. (brainkart.com)

Propensity1

• Within the confines of propensity score matching, our results suggest that aprotinin may be associated with renal dysfunction. (doctime.es)

Patients3

• Further, when CU-2010 and CU-2020 are continuously infused, the greater inhibition of factors Xa and XIa compared to that by aprotinin prevent early thrombosis, providing an anti-coagulatory effect in patients, and prolonging activated partial thromboplastin time (aPTT). (wikipedia.org)
• METHODS After appropriate statistical design and institutional review board approval, eligible patients who were scheduled for extrapleural pneumonectomy were randomized to receive either aprotinin or placebo during the operation. (transfusionevidencelibrary.com)
• In contrast, 7 of 11 patients who received aprotinin remained alive at the time of the current report. (transfusionevidencelibrary.com)

Blood loss2

• Aprotinin is a basic proteinase inhibitor obtained from bovine organs, and is given intravenously to reduce peri-operative blood loss in open heart surgeries. (brainkart.com)
• CONCLUSIONS Aprotinin decreased blood loss. (transfusionevidencelibrary.com)

Effects2

• His lab also investigates the effects of cardiopulmonary bypass and a novel technique for long-term cardiac preservation for transplantation. (utswmed.org)
• After accounting for covariate effects, there was a significant comparative benefit with aprotinin in postoperative survival. (transfusionevidencelibrary.com)

Risk1

• CU-2010 and CU-2020 were developed to avoid many issues associated with the use of aprotinin, including the risk of an allergic reaction and infection. (wikipedia.org)

Similar2

• CU-2010 and CU-2020 have the ability to inhibit plasmin to a similar extent as aprotinin, but they are 100,000 times better at inhibiting factor Xa and factor Xia. (wikipedia.org)
• An immunoreactivity with bikunin and TFPI was not detected, Similar results were obtained with polyclonal anti-aprotinin antibodies from rabbit. (uni-bielefeld.de)

Release2

• Babin-Ebell J, Misoph M, Müllges W, Elert O. Cytokine release during cardiopulmonary bypass related to roller / centrifugal pumps: effect of pump-type on cytokine release. (2medicalcare.com)
• Babin-Ebell J, Misoph M, Müllges W, Neukam K, Elert O. Reduced release of tissue factor by application of a centrifugal pump during cardiopulmonary baypass. (2medicalcare.com)

Function2

• CU-2010 and CU-2020 improve coronary endothelial function similarly to aprotinin. (wikipedia.org)
• Effect of low-dose Aprotinin on Postoperative Bleeding and Renal Function after Cardiopulmonary Bypa. (jchestsurg.org)

Years2

• Forty years of clinical aprotinin use: a review of 124 hypersensitivity reactions. (uni-bielefeld.de)
• Cardiopulmonary Bypass after 50 Years. (stanford.edu)

Management1

• Review article: heparin sensitivity and resistance: management during cardiopulmonary bypass. (unboundmedicine.com)

Heart1

• Brinkmann T, Korfer R, Wenzel H, Tschesche H, Kleesiek K. Strong crossreaction of human anti-aprotinin antibodies from heart transplant patient with [Arg(15)]aprotinin. (uni-bielefeld.de)