Protocol of Cole et al for Use of Aprotinin in Children Undergoing Spinal Surgery

Description

Aprotinin is a serine protease inhibitor that is prepared from bovine lung and which inhibits fibrinolysis. Administration to patients during surgery can reduce bleeding and consequently blood transfusion needs. Cole et al used a protocol for children undergoing prolonged spinal surgery.

Aprotinin is given as an infusion through a central line. The dose is based on the patient's body surface area (BSA).

	Loading Dose	Maintenance Dose
BSA <= 1 square meter	240 mg per square meter BSA	56 mg per square meter BSA per hour.
BSA > 1 square meter	280 mg (200 mL)	70 mg per hour (50 mL)
administration	over the 30 minutes prior to making the initial incision	after the loading dose, during surgery and for 4 hours after surgery

where:

• Aprotinin is supplied as a solution with 1.4 mg/mL, which provides 10,000 Kallikrein Inhibitor Units (KIU) per mL.

• In the administration of Trasylol (aprotinin injection) in the PDR it is recommended that a test dose of 1 mL be given 10 minutes prior to the loading dose to detect a possible allergic reaction.

• The dosage regimen is comparable to the high dose aprotinin regimen (see PDR).

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Description

Specialty

ICD-10