tailieunhanh - Báo cáo khoa học: "A disheartening story: Aprotinin in cardiac surgery"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care giúp cho các bạn có thêm kiến thức về ngành y học đề tài: A disheartening story: Aprotinin in cardiac surgery. | Available online at http content 10 6 317 University of Pittsburgh Department of Critical Care Medicine Evidence-Based Medicine Journal Club EBM Journal Club Section Editor Eric B. Milbrandt MD MPH Journal club critique A disheartening story Aprotinin in cardiac surgery Marcus Lien1 and Eric B. Milbrandt2 1 Clinical Fellow Department of Critical Care Medicine University of Pittsburgh School of Medicine Pittsburgh Pennsylvania USA 2 Assistant Professor Department of Critical Care Medicine University of Pittsburgh School of Medicine Pittsburgh Pennsylvania USA Published online 8 November This article is online at http content 10 6 317 2006 BioMed Central Ltd Critical Care 2006 10 317 DOI 101186 cc5072 Expanded Abstract Citation Mangano DT Tudor IC Dietzel C The risk associated with aprotinin in cardiac surgery. N Engl J Med 2006 354 353365 1 . Background The majority of patients undergoing surgical treatment for ST-elevation myocardial infarction receive antifibrinolytic therapy to limit blood loss. This approach appears counterintuitive to the accepted medical treatment of the same condition--namely fibrinolysis to limit thrombosis. Despite this concern no independent large-scale safety assessment has been undertaken. Methods Design and setting Prospective observational cohort study in 69 institutions in North and South America the Middle East Europe and Asia. Subjects 4374 patients undergoing coronary-artery revascularization. All patients were 18 years old and completed a pre-surgery interview. Patients were classified as undergoing primary surgery no previous heart surgery and no other surgery besides a coronary artery bypass graft or complex surgery all other surgery . Intervention None. Measurements The authors prospectively assessed three agents aprotinin 1295 patients aminocaproic acid 883 and tranexamic acid 822 as compared with no agent 1374 patients with regard to serious cardiovascular renal and cerebrovascular outcomes by .