Comparison of the effects of aprotinin and tranexamic acid on blood loss and related variables after cardiopulmonary bypass.

@article{Blauhut1994ComparisonOT,
  title={Comparison of the effects of aprotinin and tranexamic acid on blood loss and related variables after cardiopulmonary bypass.},
  author={Barbara Blauhut and Wolfgang Harringer and Peter Bettelheim and Jan Eva Doran and Peter Sp{\"a}th and Per Lundsgaard-Hansen},
  journal={The Journal of thoracic and cardiovascular surgery},
  year={1994},
  volume={108 6},
  pages={
          1083-91
        }
}
The influence of aprotinin and tranexamic acid on platelet function and postoperative blood loss in cardiac surgery.
TLDR
Platelet function measured by whole blood aggregometry is better preserved by aprotinin than tranexamic acid and may be responsible for producing less bleeding within the first 24 h after CPB.
Tranexamic Acid and Aprotinin Reduce Postoperative Bleeding and Transfusions During Primary Coronary Revascularization
TLDR
The data show that TA is equivalent to aprotinin for blood conservation in patients at risk of excessive post-CPB bleeding and transfusion therapy, and help to support the use of pharmacologic methods to improve clinically relevant indicators of blood conservation for primary CPB procedures.
Impact of tranexamic acid vs. aprotinin on blood loss and transfusion requirements after cardiopulmonary bypass: a prospective, randomised, double-blind trial
TLDR
TA appears to be a cost-effective alternative to AP in primary CABG patients, and a difference in blood loss between TA and high-dose AP is shown, although statistically significant, it has little clinical relevance.
Aprotinin: an update of its pharmacology and therapeutic use in open heart surgery and coronary artery bypass surgery.
TLDR
Comparative tolerability and cost-effectiveness data for aprotinin and the lysine analogues are required to more fully assess their individual roles in reducing blood loss and transfusion requirements in patients undergoing CPB during OHS and/or CABG.
Benefits and Risks of Aprotinin Use During Cardiac Surgery
TLDR
Clinicians should reserve its use for patients at high risk for postoperative blood loss, and the use of aprotinin could be considered as one component of a blood conservation strategy.
Is e-Aminocaproic Acid as Effective as Aprotinin in Reducing Bleeding With Cardiac Surgery ?
TLDR
e-Aminocaproic acid and aprotinin had no effect on risks of postoperative myocardial infarction or overall mortality, and considerably less-expensive e-aminocapROic acid may be preferred over aProtinin for reducing hemorrhage with cardiac surgery.
Is ε-Aminocaproic Acid as Effective as Aprotinin in Reducing Bleeding With Cardiac Surgery? A Meta-Analysis
TLDR
A meta-analysis of 52 randomized clinical trials published between 1985 and 1998 revealed substantial reductions in total blood loss with e-aminocaproic acid and low-dose aprotinin.
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References

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Influence of high-dose aprotinin treatment on blood loss and coagulation patterns in patients undergoing myocardial revascularization.
TLDR
Intraoperative administration of the proteinase inhibitor aprotinin causes reduction in blood loss and homologous blood requirement in patients undergoing cardiac surgery and remained significantly increased until heparin was neutralized after cardiopulmonary bypass (CPB).
Hemostatic Effects of Tranexamic Acid and Desmopressin During Cardiac Surgery
TLDR
Desmopressin exerts no hemostatic effect, with or without prior administration of antifibrinolytic drug, and tranexamic acid alone appears economical and safe in decreasing blood loss and transfusion requirement after cardiac surgery.
Aprotinin Prevents Cardiopulmonary Bypass‐Induced Platelet Dysfunction: A Scanning Electron Microscope Study
TLDR
By preserving platelet function, aprotinin improves postoperative hemostasis in all patients who receive high dose and in most who receive low dose.
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