Effect of different doses of aprotinin on perioperative inflammatory response in patients undergoing off-pump coronary artery bypass surgery / 中华麻醉学杂志

ABSTRACT

Objective To investigate the effect of full-dose and half-dose aprotinin on perioperative inflammatory response in patients undergoing off-pump coronary artery bypass grafting (CABG) .Methods Thirty-nine patients aged 50-65 yrs undergoing off-pump CABG were randomly divided into 3 groups (n = 13 each):Ⅰcontrol group (C);Ⅱfull-dose aprotinin group (A-full) andⅢhalf-dose aprotinin group (A-half) . In groupⅡ( A-full) aprotinin 2?106 KIU in 100 ml normal saline (NS) was infused over 30 min after induction of anesthesia followed by aprotinin infusion at 0.5?106 KIU?h-1 until the end of surgery. In group A-half, half the amount of aprotinin administered in group A-full was given. In control group only NS was administered. Blood samples were taken before operation (T1,baseline) , 0.5 h after completion of vascular anastomosis (T2) and 2, 6, 18 h after operation (T3-5), for determination of plasma concentrations of IL-10, IL-6 and troponin (TnI) .Results The 3 groups were comparable with respect to age, M/F ratio, duration of operation and the number of bypass grafts. Plasma concentrations of IL-10, IL-6 and TnI were significantly increased after operation as compared to the baseline values (T0) in all 3 groups. The plasma concentrations of IL-10, IL-6 and TnI were significantly lower and postoperative blood loss smaller in the 2 aprotinin groups than in the control group; but they were not significantly different between the two aprotinin groups. Conclusion Both full-dose and half-dose aprotinin can inhibit the inflammatory response to CABG, reduce myocardial injury and postoperative blood loss. Half-dose aprotinin is recommended in patients undergoing off-pump CABG.