The use of high doses of aprotinin to decrease blood loss in aortocoronary by-pass surgery.

There were examined 100 patients who had been operated in extracorporeal circulation for ischemic heart disease. In the 1st group (50 patients), each patient intraoperatively received 6,000,000 KIE of aprotinin; in the 2nd group (50 patients) placebo. Both groups were similar as for the age, duration of extracorporeal circulation, and myocardium anoxia. The total intraoperative blood loss was higher in 2nd group, 638 +/- 5 ml and 952.4 +/- 15.5 ml p < 0.05 correspondingly. The rate of cases without the intraoperative use of donor blood was 42% in group 1 and 18% in group 2. The postoperative blood loss was significantly lower with the use of aprotinin, 392 +/- 6.6 ml and 689.7 +/- 9.6 ml, p < 0.05 correspondingly; and in that the Hb concentration in the drainage blood was higher in group 2: 31.3 +/- 0.5 g and 73.1 +/- 2.2 g, p < 0.05. In group 1 22% of the patients received donor blood in the early postoperative period, and group 2 twice as many -56%. Thus prolonged intraoperative use of large aprotinin dosages in aortocoronary by-pass surgery is an effective means for stabilization of homeostasis, and it allows to reduce intra- and postoperative blood loss and diminishes the requirements in donor blood.