http://hdl.handle.net/10171/175 2013-06-19T00:14:32Z http://hdl.handle.net/10171/29257 Title: Reducción de los requerimientos de hemoderivados en el trasplante hepático con aprotinina Author(s) : Monedero, P. (Pablo); Paramo, J.A. (José Antonio); Carrascosa, F. (Francisco); Herrero, J.I. (José Ignacio); Hidalgo, F. (Francisco); Iribarren, M.J. (M.J.); Garcia-Pedrajas, F. (F.) Abstract: Prophylactic use of aprotinin during surgery has a beneficial effect on hemostatic mechanisms, reducing the need for blood products. A reduction in fibrinolysis seems to contribute to this effect. 1994-12-31T23:00:00Z http://hdl.handle.net/10171/23800 Title: Inflation of the endotracheal tube cuff in the pharynx for ventilation of paralyzed patients with unanticipated difficult airway Author(s) : Panadero, A. (Alfredo); Monedero, P. (Pablo); Olavide, I. (Isidro); Fernandez-Liesa, I. (Ignacio); Mendieta, J.M. (José Manuel); Macias, A. (Antonio) 1998-12-31T23:00:00Z http://hdl.handle.net/10171/22910 Title: Randomized study of aprotinin and DDAVP to reduce postoperative bleeding after cardiopulmonary bypass surgery Author(s) : Rocha, E. (Eduardo); Hidalgo, F. (Francisco); Llorens, R. (Rafael); Melero, J.M. (José María); Arroyo, J.L. (José L.); Paramo, J.A. (José Antonio) Abstract: BACKGROUND: Patients on cardiopulmonary bypass (CPB) have an increased susceptibility to postoperative bleeding. Previous reports using desmopressin acetate (DDAVP) for the prevention of postoperative bleeding have given contradictory results, whereas the protease inhibitor aprotinin has been shown to reduce blood loss after this type of surgery. This randomized study was performed to assess the efficacy of DDAVP versus aprotinin in the prevention of bleeding after CPB. METHODS AND RESULTS: One hundred nine of 122 eligible patients were randomized to four different groups: Group A (n = 28) received aprotinin starting with a bolus of 2 x 10(6) KIU followed by a continuous infusion of 0.5 x 10(6) KIU/h until the end of surgery; group B (n = 25) received of DDAVP 0.3 micrograms/kg i.v. on completion of CPB; group C (n = 28) received two doses of DDAVP, the first as in group B and an additional dose 6 hours after surgery; group D (n = 28) received no treatment. There was a marked reduction of postoperative blood loss either at 12 hours (P < .01) or 72 hours (P < .02) in the aprotinin group compared with all other groups, whereas no significant effect was observed in either of the two DDAVP regimens. A significant reduction in the amount of blood used was observed only in the aprotinin group (P < .01). Of the plasma fibrinolytic components assayed, there was a significant reduction of the fibrin degradation product generation in the aprotinin group (P < .001), whereas a significant systemic hyperfibrinolysis was observed in both DDAVP-treated groups and the control group. No side effects related to the study drugs were observed in any patient. CONCLUSIONS: Aprotinin inhibited fibrinolysis; this correlated with a significant reduction of postoperative blood loss and need for blood replacement after CPB. Neither one nor two doses of DDAVP had a beneficial effect. Aprotinin offers a better alternative than DDAVP in the prevention of bleeding after CPB. 1993-12-31T23:00:00Z