Aprotinin, that is a question
" The former use of aprotinin affected the concepts of heparinization for CPB for intracardiac surgery, because this agent prolongs both clotting time and ACT, depending on the method of measurement. If aprotinin is used, an optimal recommendation is to administer the usual initial dose of heparin and add additional heparin to maintain the ACT above 700 seconds if the activating agent is Celite (diatomaceous earth). Kaolin is a more dependable activating agent, giving ACTs in the presence of aprotinin similar to those without aprotinin in vitro and during CPB. Therefore, a preferable method when aprotinin is used during CPB is to use kaolin as the activating agent and maintain the usual ACT at 480 seconds. Alternatively, the heparin concentration is measured at intervals and kept above 3 mg · kg−1. Because of results of randomized trials demonstrating that aprotinin was associated with a higher risk of death after cardiac surgical procedures than other antifibrino...