China
Africa
Explore chapters and articles related to this topic
Blood and blood component use in cardiac surgery or ‘why do cardiac surgical patients bleed?’
Published in Jennifer Duguid, Lawrence Tim Goodnough, Michael J. Desmond, Transfusion Medicine in Practice, 2020
Robert R Jeffrey, Michael J Desmond
There has been no randomized controlled study showing that routine platelet administration reduces postoperative bleeding or allogeneic blood requirements following cardiac surgery. However, the importance of appropriate platelet transfusion in those patients who attend on preoperative aspirin therapy cannot be underestimated. Aprotinin has been demonstrated to reduce the postoperative bleeding in such patients, and its use should be considered in aspirin-pretreated patients.
Anesthesia for Patients with Ventricular Assist Devices
Published in Wayne E. Richenbacher, Mechanical Circulatory Support, 2020
Bleeding and coagulation disorders are a common problem in patients undergoing VAD placement, especially those who have had a prior cardiac surgery. Aprotinin, a bovine serine protease inhibitor, has been used extensively in patients undergoing cardiac operations in an effort to minimize perioperative blood loss, prevent potential complications associated with blood transfusions and the need for reoperations for control of bleeding. Aprotinin inhibits the activity of kallikrein and plasmin, thereby effectively serving as an antifibrinolytic agent.
Acquired Bleeding Disorders Associated with the Character of the Surgery
Published in Harold R. Schumacher, William A. Rock, Sanford A. Stass, Handbook of Hematologic Pathology, 2019
William A. Rock, Robert F. Baugh
Aprotinin is an anticoagulant, but its mechanism of action is such that it does not effectively inhibit thrombin generated by surgery. In CV surgery, it must be used with a drug that can block thrombin, in this case, heparin. However, since heparin is normally monitored with an activated clotting time, and aprotinin inhibits kallikrein, the heparin must be followed in some other manner. The impact of both aprotinin and heparin on activated clotting time are not additive and depend to some extent on the type of activator being used in the activated clotting time test (52–55). If aprotinin is being used, an independent method for monitoring heparin should be considered. There have been several instances of lethal thromboses developing in cases where aprotinin was used, but heparin was followed only using an activated clotting time.
Zika virus pathogenesis and current therapeutic advances
Published in Pathogens and Global Health, 2021
Caroline Mwaliko, Raphael Nyaruaba, Lu Zhao, Evans Atoni, Samuel Karungu, Matilu Mwau, Dimitri Lavillette, Han Xia, Zhiming Yuan
The ZIKV NS2B-NS3 protease and NS3-helicase play a major role in viral replication. Consequently, several compounds have been developed to target these two proteins. Natural flavonoids, including myricetin, quercetin, luteolin, isorhamnetin and apigerin, have been shown to noncompetitively inhibit ZIKV protease [122]. Lopinavir-ritonavir and novobiocin have also been shown to exhibit anti-ZIKV effects [123]. Novobiocin was shown to protect mice against a lethal ZIKV challenge, reducing viremia and histopathological damage [123]. Erythrosin B, a category B drug, was found to noncompetitively inhibit DENV2 and ZIKV NS2B-NS3 proteases [124] and was also shown to reduce viral titers in YFV, JEV, and WNV, with low cytotoxicity and a micromolar potency [124]. In a screening of 2816 approved drugs, 3 potent drugs, temoporfin, niclosamide, and nitazoxanide, were identified as inhibitors of ZIKV protease [107]. Moreover, temoporfin was shown to inhibit ZIKV replication in human placental cells and protected mice from succumbing to ZIKV infection [107]. Aprotinin, used to reduce bleeding during complex surgery [125], and bromocriptine [126] were found to be potent inhibitors of ZIKV NS2B-NS3. In both, molecular models were developed to predict binding with the NS2B-NS3 protease.
Injection therapies for patellar tendinopathy
Published in The Physician and Sportsmedicine, 2020
Aprotinin is a collagenase inhibitor and a strong inhibitor of matrix metalloproteinases (MMP) [62]. It has been postulated there is an increase in MMP in tendinopathic tissues. This excessive collagenase may lead to a delayed recovery in tendinopathic patients [63]. A local injection of a collagenase inhibitor such as aprotinin can be used as an effective management option for tendinopathies. Only two studies are available in the literature regarding the effectiveness of aprotinin injections in the management of tendinopathies [30,64]. Capasso, Testa [30] reported a long lasting beneficial effect of the local injection of aprotinin in PT patients. A retrospective cohort study also showed good clinical improvement in the symptoms of tendinopathy following aprotinin injection [64]. However, there was no control group in the study and the outcome measure were patient opinions about their condition. Although the results are promising, it is not possible to draw a conclusion on the effectiveness of aprotinin injections on PT based on these studies. Aprotinin has been withdrawn worldwide due to its side effects when injected intravenously during cardiac surgery.
Risk factors and treatment of refractory anaphylaxis - a review of case reports
Published in Expert Review of Clinical Immunology, 2018
Wojciech Francuzik, Sabine Dölle, Margitta Worm
There also was a report where the patient was inadvertently given i.v. high dose of aprotinin in a fast infusion. After 10 h of refractory hypotension, authors decided to use the last resort treatment with high-volume continuous veno-venous hemofiltration which resulted in a rapid improvement of hemodynamic function [53].