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Aprotinin improves functional outcome but not cerebral infarct size in an experimental model of stroke during cardiopulmonary bypass.

Publication ,  Journal Article
Homi, HM; Sheng, H; Arepally, GM; Mackensen, GB; Grocott, HP
Published in: Anesth Analg
July 2010

BACKGROUND: Aprotinin, a nonspecific serine protease inhibitor, has been used to decrease bleeding and reduce the systemic inflammatory response after cardiopulmonary bypass (CPB). Studies have variably linked aprotinin administration with both improved as well as adverse cerebral consequences after cardiac surgery. We designed this study to determine whether an antiinflammatory dose of aprotinin could improve the histologic and functional neurologic outcome in a rat model of focal cerebral ischemia during CPB. METHODS: After surgical preparation, the animals were randomized into 2 groups: an aprotinin group (60,000 kIU/kg IV) and a control group (0.9% NaCl IV). Normothermic CPB was performed for 60 minutes during which time a partial overlapping 60 minutes of right middle cerebral artery occlusion was induced. Cytokines (tumor necrosis factor-alpha, interleukin [IL]-1beta, IL-6, and IL-10) were measured at baseline, the end of CPB, then 2 and 24 hours after CPB. On postoperative day 3, the animals underwent functional neurologic testing and histologic assessment of cerebral infarct volume. RESULTS: There was a reduction in systemic inflammation in the aprotinin group compared with the control group, demonstrated by lower levels of IL-1beta (P = 0.035) and IL-6 (P = 0.047). The aprotinin group also had a better functional neurologic performance (median [interquartile range]: aprotinin 27 [8] vs control 32 [6]; P = 0.042). However, there was no difference in cerebral infarct volume (aprotinin 306 [27] mm(3) vs control 297 [52] mm(3); P = 0.599). CONCLUSIONS: In this experimental model of stroke occurring during CPB, aprotinin decreased the systemic inflammatory response to CPB. Although there was no difference in the cerebral infarct volume, there was a small improvement in the short-term functional neurologic outcome in the aprotinin group.

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Published In

Anesth Analg

DOI

EISSN

1526-7598

Publication Date

July 2010

Volume

111

Issue

1

Start / End Page

38 / 45

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Thrombin
  • Stroke
  • Serine Proteinase Inhibitors
  • Recovery of Function
  • Rats, Wistar
  • Rats
  • Male
  • Kallikreins
  • Hemodynamics
 

Citation

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Chicago
ICMJE
MLA
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Homi, H. M., Sheng, H., Arepally, G. M., Mackensen, G. B., & Grocott, H. P. (2010). Aprotinin improves functional outcome but not cerebral infarct size in an experimental model of stroke during cardiopulmonary bypass. Anesth Analg, 111(1), 38–45. https://doi.org/10.1213/ANE.0b013e3181e0549f
Homi, H Mayumi, Huaxin Sheng, Gowthami M. Arepally, G Burkhard Mackensen, and Hilary P. Grocott. “Aprotinin improves functional outcome but not cerebral infarct size in an experimental model of stroke during cardiopulmonary bypass.Anesth Analg 111, no. 1 (July 2010): 38–45. https://doi.org/10.1213/ANE.0b013e3181e0549f.
Homi HM, Sheng H, Arepally GM, Mackensen GB, Grocott HP. Aprotinin improves functional outcome but not cerebral infarct size in an experimental model of stroke during cardiopulmonary bypass. Anesth Analg. 2010 Jul;111(1):38–45.
Homi, H. Mayumi, et al. “Aprotinin improves functional outcome but not cerebral infarct size in an experimental model of stroke during cardiopulmonary bypass.Anesth Analg, vol. 111, no. 1, July 2010, pp. 38–45. Pubmed, doi:10.1213/ANE.0b013e3181e0549f.
Homi HM, Sheng H, Arepally GM, Mackensen GB, Grocott HP. Aprotinin improves functional outcome but not cerebral infarct size in an experimental model of stroke during cardiopulmonary bypass. Anesth Analg. 2010 Jul;111(1):38–45.

Published In

Anesth Analg

DOI

EISSN

1526-7598

Publication Date

July 2010

Volume

111

Issue

1

Start / End Page

38 / 45

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Thrombin
  • Stroke
  • Serine Proteinase Inhibitors
  • Recovery of Function
  • Rats, Wistar
  • Rats
  • Male
  • Kallikreins
  • Hemodynamics