High-dose aprotinin, blood product transfusions, and short-term outcome in neonates and infants: a pediatric cardiac surgery center experience

Paediatric Anaesthesia,

No association was found between the prophylactic use of aprotinin, blood product transfusions, and short–term outcome in this population of neonates and infants.

Methods

  • This retrospective study included all patients younger than 1year undergoing surgery with cardiopulmonary bypass through 42months, before and after withdrawal of aprotinin.
  • Each patient who received aprotinin was matched with a control with similar baseline and surgical characteristics, who have not received any antifibrinolytic agent.
  • Associations between the use of aprotinin and the exposure to red blood cells, fresh frozen plasma, and platelet transfusions were estimated from a logistic regression model, and the exposure to additional transfusions from a polytomous regression model.

Results

  • Matching resulted in two groups of 283 patients each, well balanced except for the priming volume and the ultrafiltration rate, larger in the aprotinin group.
  • After adjustment for the priming volume and ultrafiltration rate, there was no significant association between the use of aprotinin, the exposure to any blood product transfusion, or the exposure to additional transfusions, the rate of re–exploration for bleeding, and short–term outcome.
  • Two patients in the control group required re–exploration for bleeding.

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