الفهرس 
Material and methodsOnly 14 pages are availabe for public view
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Abstract
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SUMMARY AND CONCLUSION
Cardiopulmonary bypass causes a major increase in fibrinolytic activity that has been associated with an increase risk for haemorrhage during and immediately after cardiac surgery.
Contact of the blood with a large artificial surface leads to activation of the contact phase of coagulation via activation of factor XII, pre kallikrein and high molecular weight kininogen
which initiate the intrinsic pathway of coagulation.
To prevent gross clot formation during CPB, heparin is
commonly used as an anticoagulant. There is a wide variability in dividual patients to the action of heparin. can not completely inhibit thrombin which leads to fibrin formation and
The platelets are activated by either the contact with the artificial surfaces of the heart-lung machine or via stimulation by
thrombin or plasmin.
the sensitivity of the in In addition, heparin formation and action activation of fibrinolysis
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Aprotinin is a naturally occurring serine protease inhibitor isolated from bovine lung tissues, reduces blood loss following cardiopulmonary bypass operations by the prevention of hyperfibrinolysis.
In this study we investigated the effect of aprotinin on blood loss, homologous blood transfusion and coagulation patterns in patients undergoing open heart surgery.
Forty patients were studied, we divided the patients into two groups, group (A) twenty patients received high-dose of aprotinin and control group (C) twenty patients did not receive
aprotinin.
To study the effect of aprotinin we measured the total blood loss, the amount of transfused homologous blood and the haematological parameters including haemoglobin concentration, haematocrit value, platelet count, bleeding time, fibrinogen level, thrombin time, prothrombin time, activated partial thromboplastin time, activated clotting time, D-dimer and fibrinopeptide-A. This study demonstrated that high-dose aprotinin significantly reduced the total blood loss and the requirement of blood transfusion in
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patients undergoing cardiopulmonary bypass by reducing fibrinolysis.
This evidenced by generation a significantly fewer thrombin, D-dimer and fibrinopeptide-A in aprotinin-treated group than control group. The effect of aprotinin on platelet is
uncertain.