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In Nordic countries 30-day mortality rate is half that estimated with EuroSCORE II in high-risk adult patients given aprotinin and undergoing mainly complex cardiac procedures.
Scand Cardiovasc J
December 2024
Department of Anesthesiology, Helsinki University Hospital, Helsinki, Finland.
To describe current on- (isolated coronary arterty bypass grafting, iCABG) and off-label (non-iCABG) use of aprotinin and associated safety endpoints in adult patients undergoing high-risk cardiac surgery in Nordic countries. Data come from 10 cardiac surgery centres in Finland, Norway and Sweden participating in the European Nordic aprotinin patient registry (NAPaR). 486 patients were given aprotinin between 2016 and 2020.
View Article and Find Full Text PDFUse and safety of aprotinin in routine clinical practice: A European postauthorisation safety study conducted in patients undergoing cardiac surgery.
Eur J Anaesthesiol
August 2022
From the Department of Anaesthesiology and Perioperative Medicine, Ghent University Hospital - Ghent University, Corneel Heymanslaan 10, Ghent, Belgium (SDH), CHU Bordeaux, Department of Anaesthesia and Critical Care Diseases (AO), Univ. Bordeaux, INSERM, UMR 1034, Biology and Cardiovascular Diseases, Pessac, France (AO), Anaesthetics Department, RBH Foundation Trust, Harefield Hospital, Hill End Rd Harefield, Uxbridge, UK (DR), Department of Perioperative Medicine, Section of Cardiothoracic Anaesthesiology and Intensive Care, Karolinska University Hospital, Solna, Stockholm, Sweden (JVDL) and Department of Anaesthesiology, Intensive Care Medicine & Pain Therapy at the University Hospital Frankfurt, Theodor-Stern-Kai 7, Goethe University, Frankfurt am Main, Germany (KZ).
Background: Aprotinin has been used to reduce blood loss and blood product transfusions in patients at high risk of major blood loss during cardiac surgery. Approval by the European Medicines Agency (EMA) for its current indication is limited to patients at high risk of major blood loss undergoing isolated coronary artery bypass graft surgery (iCABG).
Objective: To report current real-world data on the use and certain endpoints related to the safety of aprotinin in adult patients.
Pharmacologic methods to reduce postoperative bleeding in adult cardiac surgery. A mini-review.
Curr Pharm Des
April 2014
Department of Cardiothoracic Surgery, Aalborg Hospital, Aarhus University Hospital, Hobrovej, P.O. Box 365, 9100 Aalborg, Denmark.
Because blood for transfusion is a scarce resource and since allogeneic transfusion may even be harmful, there is a growing awareness among surgeons and anesthesiologists regarding the use of multimodal blood conservation programs in cardiac surgery in order to reduce bleeding, transfusion and re-exploration. Pharmacologic methods should be part of a multimodal blood conservation programs. Three drugs for anti-fibrinolytic prophylaxis have been available for more than two decades: Aprotinin, tranexamic acid and epsilon aminocaproic acid.
View Article and Find Full Text PDFPerioperative allergy: uncommon agents.
Int J Immunopathol Pharmacol
January 2012
Department of Pediatrics, University of Pavia, Italy.
Anesthesia may often be considered as a high-risk procedure and anaphylaxis remains a major cause of concern for anesthetists who routinely administer many potentially allergenic agents. Neuromuscular blocking agents, latex and antibiotics are the substances involved in most of the reported reactions. Besides these three agents, a wide variety of substances may cause an anaphylactic reaction during anesthesia.
View Article and Find Full Text PDFComparison between TachoComb and TachoSil for surgical hemostasis in arterial bleeding: an animal experimental study.
J Trauma
April 2010
Department of Cardiothoracic and Vascular Surgery, Institute of Clinical Medicine, Aarhus University Hospital, Skejby, Aarhus, Denmark.
Background: TachoComb has frequently been used for the treatment of both venous and arterial bleeding. However, anaphylactic reactions have been reported after repeated use of hemostatic agents containing aprotinin such as TachoComb. Because aprotinin is also associated with risk of renal failure, manufacturing of a new product--TachoSil--which lacks aprotinin seems a logic evolvement.
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