[HSF] More Bad News About Trasylol

[hgrmd at aol.com]

Ben,
  You really aren't certain that aprotinin increases the incidence of ATN???  That is at odds with practically everything I've read or anyone I've discussed about the drug.  I agree that a lot of ATN can just be observed, as it will frequently resolve in a few days. As for HD, I frequently see the patient need dialysis for removing volume rather than electrolyte abnormalities.  The choice is often HD or reintubation. This is probably inherent to the brittle range of fluid balance seen in patients with valvular disease and often impaired ventricles.  
Hal 
 
 
-----Original Message-----
From: benjamin.bidstrup at bigpond.com
To: OpenHeart-L at lists.hsforum.com
Sent: Sun, 1 Oct 2006 9:48 AM
Subject: Re: [HSF] More Bad News About Trasylol


>Ben, 
> With your pioneering work with aprotinin as well as your extensive >clinical experience with the drug, do you believe that aprotinin >increases the odds 
>of ATN? If so, do you agree that postop ATN is associated with at least a 
>20-30% mortality? 
>Hal 
>_______________________________________________ 
No 
 
and 
 
New renal dialysis after cardiac surgery is associated with a higher mortality in most of the reviews I have looked at. Not all ATN results in dialysis - we often sit it out if the electrolytes etc. do not go haywire. It is the dialysis that seems to increase the risks. 
 
Whether aprotinin contributes to that is not certain. 
-- Ben Bidstrup FRACS FRCSEd FEBCTS 
Consultant Cardiothoracic Surgeon 
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