• J Bone Joint Surg Am · May 2005

    Review

    Evidence-based review of the role of aprotinin in blood conservation during orthopaedic surgery.

    • Agnieszka Kokoszka, Paul Kuflik, Fabien Bitan, Andrew Casden, and Michael Neuwirth.
    • Spine Institute, Beth Israel Medical Center, New York, NY 10003, USA. agnieszka.kokoszka@mail.hsc.sunysb.edu
    • J Bone Joint Surg Am. 2005 May 1; 87 (5): 1129-36.

    AbstractAprotinin is a serine protease inhibitor with antifibrinolytic properties that has been approved as a blood-conserving drug in cardiac surgery by the United States Food and Drug Administration. On the basis of the current evidence from Level-I trials, we make a grade-A recommendation for use of the high-dose aprotinin regimen in hip and spine surgery. Because of conflicting data, the low-dose aprotinin therapy as well as the use of aprotinin in patients with cancer cannot be recommended (grade-I recommendation). High-quality randomized trials are necessary to determine the optimal (and minimal) therapeutic dose of aprotinin and the optimal time of aprotinin administration during surgery.

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