[HSF] Aprotinin

[Donald Ross]

Just a word on aprotinin and platelet poisons.
We have the latest TEG machine and have found it to be unreliable for  
diagnosing platelet dysfunction prior to surgery in cases dosed up  
with aspirin or clopidogrel.
I use the very cheap eyeball test of the state of bleeding prior to  
heparin. We all know what a coagulopathy looks like clinically after  
the sternum has been split. I only use aprotinin in this situation if  
I make the diagnosis clinically. The TEG has false positive and  
negative errors according to clinical bleeding associated with  
clopidogrel.
This is not to denigrate its use for diagnosis in post op coagulopathy.
Don