Abstract
Objective: Although aprotinin has been widely used to reduce perioperative blood loss after cardiopulmonary bypass, recent concerns have led to its withdrawal. This study investigated effects of the novel synthetic serine protease inhibitors CU-2010 and CU-2020 on blood loss, coagulation parameters, and coronary relaxation in a canine model. Methods: Thirty-seven dogs were divided into 5 groups: control (n = 5), aprotinin (n = 8, Hammersmith scheme of intravenous bolus, prime, and continuous infusion), Hammersmith CU-2010 (n = 8, 1.6 mg/kg Hammersmith scheme), continuous CU-2010 (n = 8, 1.6 mg/kg continuous infusion), and CU-2020 (n = 8, 8.9 mg/kg Hammersmith scheme). All animals underwent 90-minute cardiopulmonary bypass. End points were blood loss during first 2 hours after protamine and activated clotting, partial thromboplastin, and prothrombin times. At end of experiments, coronary rings were removed for in vitro testing of relaxation to acetylcholine and sodium nitroprusside. Results: Hammersmith and continuous CU-2010, CU-2020, and aprotinin groups all had reduced blood loss (43 ± 4, 43 ± 8, 52 ± 7, 61 ± 7, respectively, vs control 149 ± 24 mL, P <.05). After protamine, activated clotting time and partial thromboplastin time normalized in control, aprotinin, and Hammersmith CU-2010 groups but remained elevated in continuous CU-2010 and CU-2020 groups. Prothrombin time and vascular relaxation did not differ between groups. Conclusions: CU-2010 and CU-2020 significantly reduced blood loss after cardiac surgery, with prolonged partial thromboplastin and activated clotting times, demonstrating improved antithrombotic profile. Neither aprotinin nor the novel serine protease inhibitors influenced vascular relaxation.
| Original language | English |
|---|---|
| Pages (from-to) | 181-188 |
| Number of pages | 8 |
| Journal | Journal of Thoracic and Cardiovascular Surgery |
| Volume | 139 |
| Issue number | 1 |
| DOIs | |
| Publication status | Published - Jan 2010 |
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ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine
- Surgery
- Pulmonary and Respiratory Medicine
Cite this
Effects of novel synthetic serine protease inhibitors on postoperative blood loss, coagulation parameters, and vascular relaxation after cardiac surgery. / Szabó, G.; Veres, Gábor; Radovits, T.; Haider, Humaira; Krieger, Nelli; Bährle, Susanne; Miesel-Gröschel, Christiane; Niklisch, Silke; Karck, Matthias; van de Locht, Andreas.
In: Journal of Thoracic and Cardiovascular Surgery, Vol. 139, No. 1, 01.2010, p. 181-188.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Effects of novel synthetic serine protease inhibitors on postoperative blood loss, coagulation parameters, and vascular relaxation after cardiac surgery
AU - Szabó, G.
AU - Veres, Gábor
AU - Radovits, T.
AU - Haider, Humaira
AU - Krieger, Nelli
AU - Bährle, Susanne
AU - Miesel-Gröschel, Christiane
AU - Niklisch, Silke
AU - Karck, Matthias
AU - van de Locht, Andreas
PY - 2010/1
Y1 - 2010/1
N2 - Objective: Although aprotinin has been widely used to reduce perioperative blood loss after cardiopulmonary bypass, recent concerns have led to its withdrawal. This study investigated effects of the novel synthetic serine protease inhibitors CU-2010 and CU-2020 on blood loss, coagulation parameters, and coronary relaxation in a canine model. Methods: Thirty-seven dogs were divided into 5 groups: control (n = 5), aprotinin (n = 8, Hammersmith scheme of intravenous bolus, prime, and continuous infusion), Hammersmith CU-2010 (n = 8, 1.6 mg/kg Hammersmith scheme), continuous CU-2010 (n = 8, 1.6 mg/kg continuous infusion), and CU-2020 (n = 8, 8.9 mg/kg Hammersmith scheme). All animals underwent 90-minute cardiopulmonary bypass. End points were blood loss during first 2 hours after protamine and activated clotting, partial thromboplastin, and prothrombin times. At end of experiments, coronary rings were removed for in vitro testing of relaxation to acetylcholine and sodium nitroprusside. Results: Hammersmith and continuous CU-2010, CU-2020, and aprotinin groups all had reduced blood loss (43 ± 4, 43 ± 8, 52 ± 7, 61 ± 7, respectively, vs control 149 ± 24 mL, P <.05). After protamine, activated clotting time and partial thromboplastin time normalized in control, aprotinin, and Hammersmith CU-2010 groups but remained elevated in continuous CU-2010 and CU-2020 groups. Prothrombin time and vascular relaxation did not differ between groups. Conclusions: CU-2010 and CU-2020 significantly reduced blood loss after cardiac surgery, with prolonged partial thromboplastin and activated clotting times, demonstrating improved antithrombotic profile. Neither aprotinin nor the novel serine protease inhibitors influenced vascular relaxation.
AB - Objective: Although aprotinin has been widely used to reduce perioperative blood loss after cardiopulmonary bypass, recent concerns have led to its withdrawal. This study investigated effects of the novel synthetic serine protease inhibitors CU-2010 and CU-2020 on blood loss, coagulation parameters, and coronary relaxation in a canine model. Methods: Thirty-seven dogs were divided into 5 groups: control (n = 5), aprotinin (n = 8, Hammersmith scheme of intravenous bolus, prime, and continuous infusion), Hammersmith CU-2010 (n = 8, 1.6 mg/kg Hammersmith scheme), continuous CU-2010 (n = 8, 1.6 mg/kg continuous infusion), and CU-2020 (n = 8, 8.9 mg/kg Hammersmith scheme). All animals underwent 90-minute cardiopulmonary bypass. End points were blood loss during first 2 hours after protamine and activated clotting, partial thromboplastin, and prothrombin times. At end of experiments, coronary rings were removed for in vitro testing of relaxation to acetylcholine and sodium nitroprusside. Results: Hammersmith and continuous CU-2010, CU-2020, and aprotinin groups all had reduced blood loss (43 ± 4, 43 ± 8, 52 ± 7, 61 ± 7, respectively, vs control 149 ± 24 mL, P <.05). After protamine, activated clotting time and partial thromboplastin time normalized in control, aprotinin, and Hammersmith CU-2010 groups but remained elevated in continuous CU-2010 and CU-2020 groups. Prothrombin time and vascular relaxation did not differ between groups. Conclusions: CU-2010 and CU-2020 significantly reduced blood loss after cardiac surgery, with prolonged partial thromboplastin and activated clotting times, demonstrating improved antithrombotic profile. Neither aprotinin nor the novel serine protease inhibitors influenced vascular relaxation.
UR - http://www.scopus.com/inward/record.url?scp=73149106987&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=73149106987&partnerID=8YFLogxK
U2 - 10.1016/j.jtcvs.2009.09.019
DO - 10.1016/j.jtcvs.2009.09.019
M3 - Article
C2 - 20106364
AN - SCOPUS:73149106987
VL - 139
SP - 181
EP - 188
JO - Journal of Thoracic and Cardiovascular Surgery
JF - Journal of Thoracic and Cardiovascular Surgery
SN - 0022-5223
IS - 1
ER -