EFFECT OF HIGH-DOSE APROTININ ON BLOOD-CELL FILTERABILITY IN ASSOCIATION WITH CARDIOPULMONARY BYPASS

Background: Previous studies showed that high-dose aprotinin reduces postoperative bleeding in heart surgery and that blood cell rheologic parameters correlate to postoperative bleeding and other complications. Methods: To evaluate the blood cell rheologic effect of high-dose aprotinin in patients undergoing coronary artery bypass graft surgery, we studied 68 patients (34 receiving high-dose aprotinin during the operation) by use of a microfiltration method to assess blood cell trauma during cardiopulmonary bypass. Results: In the control group, red cell filtration rate (RFR, mu-L/s) values were significantly reduced from a preoperative level of 55.8 to a level of 37.2 on day 1 (P < 0.002) and to a level of 44.5 on day 6 (P < 0.05) after surgery. The respective values for white cell filtration rate (WFR, mu-L/s) were 17.0, 8.2 (P < 0.002), and 10.0 (P < 0.005). In the aprotinin group, RFR (mu-L/s) values were reduced, but not as significantly (58.8 preoperative, 48.1 on day 1, P > 0.05, and 50.4 on day 6, P > 0.05). The respective values for WFR (mu-L/s) were 17.5, 15.7 (P > 0.05), and 15.8 (P > 0.05). Conclusions: Blood cell rheologic function, which is known to be an important factor for adequate microcirculation and which when reduced is associated with postoperative morbidity, was shown to be protected by aprotinin in this study.