Hülya EROLÇAY, Lale YÜCEYAR, Kazım BEŞİRLİ, Bora AYKAÇ

Açık kalp cerrahisinde aprotininin kanama ve aktive edilmiş pıhtılaşma zamanına etkisi

Bu çalışmada; açık kalp cerrahisinde, antifibrinolitik bir ajan olan aprotinin kullanılmasının hemostaz ve aktive edilmiş pıhtılaşma zamanı (ACT) değerleri üzerine olan etkisi araştırıldı. Çalışmaya alınan 30 olgu aprotinin verilen ve verilmeyen olmak üzere rasgele 2 gruba ayrıldı. Aprotinin verilen grup ile (indüksiyon sonrası verilen 2 milyon KIU yükleme dozunu takiben 500 000 KIU sa-1 dozunda idame ettirildi ve ayrıca oksijenatör 'priming' ine de 2 milyon KIU eklendi) verilmeyen grup; ACT değerleri, ameliyat sonrası ilk 24 saat içindeki kanama ve homolog kan transfüzyonu miktarları açısından karşılaştırıldı. Kardiyopulmoner bypass süresince; ACT, aprotinin grubunda, kontrol grubuna göre yüksek seyretti ancak 60. ve 90. dakikalardaki yükseklik anlamlıydı (p

Anahtar Kelimeler:

Kanama zamanı, Hemostaz, Heparin, Aprotinin, Kan pıhtılaşması, Toraks cerrahisi, Kardiyopulmoner bypass

Effects of aprotinin on bleeding and activated clotting time in open heart surgery

In this study, the effects of aprotinin on hemostasis and activated clotting time (ACT) were assessed in open heart surgery. Thirty patients were randomly allocated to one of two groups to receive either aprotinin or saline. Fifteen patients in the aprotinin group received an IV bolus of 2 millions KIU. aprotinin following the induction of anesthesia and an infusion of 500 000 KIU h<sup>-1</sup> was administered throughout the operation. 2 millions KIU were added to the priming volume of oxygenator. The patients in the control group received 0.9% saline. ACT, blood loss, and homologous blood requirements of the groups in the first postoperative day were compared. In the aprotinin group, ACT remained longer than the control group during the cardiopulmonary bypass. However, this prolongation was significant only in the 60th and 90th minutes (p<0.01). In the first postoperative day, bleeding (p<0.01) and transfusion requirements (p<0.05) were significantly less in the aprotinin group. In the present study, ACT was found to be prolonged with aprotinin but returned to baseline after protamine infusion in both groups.

Keywords:

Bleeding Time, Hemostasis, Heparin, Aprotinin, Blood Coagulation, Thoracic Surgery, Cardiopulmonary Bypass,

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