[HSF] I used aprotinin today

[Tea Acuff]

Brave hematologist!
Nice job

tea


----- Original Message ----
From: "Cysmd613 at aol.com" <Cysmd613 at aol.com>
To: OpenHeart-L at lists.hsforum.com
Sent: Wednesday, November 14, 2007 9:27:57 PM
Subject: Re: [HSF] I used aprotinin today

I operated on my Jehovah's Witness patient today.  Her pre op Hgb this   
morning was 12.2 and HCT 37.4.  I "chickened out" and used amicar instead  of 
aprotinin, given that she is an 80 yo woman and with all the media   attention.  Her 
renal function is normal.  I did CABG x 5 including  LIMA and 4 SVGs.   The 
anesthesiologist took off about 350cc of blood  pre bypass.  Her HCT prior to 
coming off bypass was 22.  Her  HCT before giving back her own blood plus about 
300cc of cell saver was  24.  It took more than 30 minutes before the first 
drop of blood  came out of the mediastinal chest tube.  In the 9 hours since 
surgery, she  has put out a total of only 140cc.  I only got 1 blood gas post op  
(only because the O2 sat monitor wasn't picking up) which had her HCT at  
30.4.  She is doing very well.  She is not extubated yet because she   is still 
sleepy, but hopefully soon.
Now, post op, since her Hgb is less than 12, the hematologist is willing to  
give more procrit and IV iron.

Thank you to all who gave advice.

Carmi 



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