Do small doses of aprotinin influence the structure of platelet membranes in cardiopulmonary bypass patients?

摘要

One of the most important factors of excess bleeding following cardiosurgery is caused by platelet dysfunction due to structural damage during extracorporeal circulation. We suppose that one of aprotinins mechanisms not fully understood is its protective role concerning platelet functioning. The aim of this study was to assess the influence of small aprotinin doses on the structure of platelet membranes. The study group comprised 20 patients who underwent cardiopulmonary bypass surgery. 10 group I patients received aprotinin (Trascolam, Polfa) at a dose of 2 x106 UIC (units inactivating callikrein) mixed with the perfusion fluid. The other 10, group II patients received placebo (control group). We collected the patients blood 3 times: following the induction of anesthesia, 15 minutes after the beginning of extracorporeal circulation and 30 minutes after its termination. We examined the blood by means of the spin marker method. The suspensions spectrum was analyzed using an ESR Varian E-4 spectrometer. Our results demonstrated conformation platelet protein membrane changes in group I patients (those that received aprotinin) which consisted of loosening of their structure.