The effect of aprotinin in a model of uncontrolled hemorrhagic shock

Background: Aprotinin has been shown to promote clot formation through its antifibrinolytic activity, by inhibiting the plasmin-induced complement activation and by protecting the platelets adhesive surface receptors. It has been successfully used in cardiac and liver transplantation surgery. Objective: To evaluate the effect of aprotinin in a model of uncontrolled intra-abdominal bleeding as a basis for its potential use in trauma patients. Methods: Twenty rats were randomly divided into 2 groups. All animals were operated on and bleeding was induced by transecting 1 lobe of the liver. In the treatment group a single dose of 30,000 U/kg of aprotinin was administered 5 minutes after the injury. The animals were monitored for hemodynamic parameters, blood loss volume, and mortality rates. Results: At 120 minutes from trauma induction a significant difference in mean blood pressure was observed: 67 ± 22 mm Hg in the treatment group versus 53 ± 28 mm Hg in the control group (P = .04). This difference remained consistent until the end of the experiment. Treatment with aprotinin also resulted in a tendency to an increased survival rate (P = .05) and increased mean survival time: 175 ± 46 minutes as compared to 123 ± 48 minutes in the controls (P = .027). Conclusions: Early administration of aprotinin resulted in temporary hemodynamic stabilization and prolonged survival in a model of uncontrolled bleeding. Further studies are needed to establish the possible use of aprotinin in the treatment of trauma patients.