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Aprotinin and epsilon aminocaproic acid are effective in reducing blood loss after primary total hip arthroplasty – a prospective randomized double-blind placebo-controlled study

Ray, Michael, Hatcher, Stephen, Whitehouse, Sarah L., Crawford, Scott W., & Crawford, Ross W. (2005) Aprotinin and epsilon aminocaproic acid are effective in reducing blood loss after primary total hip arthroplasty – a prospective randomized double-blind placebo-controlled study. Journal of Thrombosis and Haemostasis, 3(7), pp. 1421-1427.

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Abstract

Summary. A prospective randomized double-blind placebo-controlled study was undertaken to determine the efficacy and mechanism of action of two antifibrinolytic drugs aprotinin and epsilon aminocaproic acid (EACA) in reducing blood loss in primary unilateral total hip arthroplasty (THA). Aprotinin was administered as a bolus of 2 × 106 kallikrein inhibitor units (KIU) followed by 0.5 × 106 KIU h1 for 3 h, EACA was given as 10 g over 30 min followed by 5 g over 3 h. The median postoperative blood loss 24 h postoperatively was reduced from 450 mL in the placebo group to 180 mL for aprotinin (60% reduction, P < 0.001) and to 210 mL for EACA (53% reduction, P < 0.01). In this population, there was no reduction in the perioperative transfusion requirements. The mechanism of both drugs was independent of platelets as indicated by flow cytometric measurement of change of their expression of P-selectin, platelet–monocyte aggregates, V/Va and CD40 ligand. There were no thrombotic or infective complications and no adverse events were attributable to use of either drug. Infusion of either aprotinin or EACA at the doses described is a safe and effective means of reducing blood loss after THA. These therapies provide a means of reducing blood loss in THA patients.

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18 citations in Scopus
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19 citations in Web of Science®

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ID Code: 5581
Item Type: Journal Article
DOI: 10.1111/j.1538-7836.2005.01457.x
ISSN: 1538-7933
Subjects: Australian and New Zealand Standard Research Classification > MEDICAL AND HEALTH SCIENCES (110000) > CLINICAL SCIENCES (110300) > Orthopaedics (110314)
Divisions: Past > QUT Faculties & Divisions > Faculty of Built Environment and Engineering
Copyright Owner: Copyright 2005 Blackwell Publishing
Copyright Statement: The definitive version is available at www.blackwell-synergy.com
Deposited On: 27 Nov 2006
Last Modified: 29 Feb 2012 23:11

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