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Sponsored by: |
Children's Healthcare of Atlanta |
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Information provided by: | Children's Healthcare of Atlanta |
ClinicalTrials.gov Identifier: | NCT00469742 |
This is a retrospective chart review study. The purpose of this study is to review our experience at Children’s Healthcare of Atlanta in neonates receiving aprotinin. We will examine the specific outcomes of renal dysfunction, thrombosis and mortality.
Condition |
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Cardiopulmonary Bypass Congenital Cardiac Defects Aprotinin |
Study Type: | Observational |
Study Design: | Natural History, Longitudinal, Defined Population, Retrospective Study |
Official Title: | Safety Profile of Aprotinin in Neonates Undergoing Cardiopulmonary Bypass: A Retrospective Chart Review |
Estimated Enrollment: | 290 |
Study Start Date: | April 2007 |
Aprotinin (Trasylol; Bayer Corporation, Pittsburgh, PA), a serine protease inhibitor isolated from bovine lung, is used intra-operatively during cardiac surgery to reduce bleeding. It is thought to work by inhibiting the contact activation phase of the coagulation cascade, reducing thrombin generation, preventing fibrinolysis and attenuating cardiopulmonary bypass (CPB)-induced platelet dysfunction.Though the efficacy of aprotinin in reducing blood loss in adults undergoing CPB is well established, its safety profile, specifically its association with renal dysfunction, thrombosis and long-term mortality, has been questioned. Although the homeostatic derangements of CPB are more significant in pediatric patients, its efficacy and safety profiles in this patient population are actually less clear. In children undergoing re-operative cardiac surgical procedures, aprotinin has been shown to be effective in attenuating post-bypass coagulopathies and decreasing blood product exposure (4). However, little information is available for neonates undergoing CPB who receive intra-operative aprotinin especially in terms of renal dysfunction and thrombosis.
All neonates who underwent Cardiopulmonary Bypass surgery (CPB) at Children's Healthcare of Atlanta between March 1, 2004 and March 1, 2007 will be candidates for this retrospective chart review. Notations will be made regarding those who received aprotinin and those who did not. Primary end points will include post-operative renal dysfunction, need for temporary dialysis, thrombosis and in-hospital mortality. Post –operative renal dysfunction will be defined as a doubling of the pre-operative creatinine level within the first 72 hours after surgery. Thrombosis found during the initial hospitalization will be considered significant. Chart review will gather demographic data (age, weight and type of surgery) as well as other data including CPB time, aortic cross clamp time, presence of regional perfusion, lowest temperature on CPB, time to chest closure, hours with a NIRS value below 40 in the first 24 hours post-op, highest recorded lactate value, blood products administered in the first 24 hours post-op, chest tube drainage in the first 24 hours post-op, first post-op weight, time to extubation and time to ICU discharge.
Ages Eligible for Study: | up to 1 Month |
Genders Eligible for Study: | Both |
Accepts Healthy Volunteers: | No |
Inclusion Criteria:
Exclusion Criteria:
Contact: Nina Guzzetta, MD | 404-785-6670 | nina.guzzetta@emoryhealthcare.org |
United States, Georgia | |
Children's Healthcare of Atlanta | Recruiting |
Atlanta, Georgia, United States, 30322 | |
Contact: Nina Guzzetta, MD 404-785-6670 nina.guzzetta@emoryhealthcare.org | |
Principal Investigator: Nina Guzzetta, MD | |
Sub-Investigator: Paul Kirshbom, MD | |
Sub-Investigator: Faye Evans, MD |
Principal Investigator: | Nina Guzzetta, MD | Emory University |
Study ID Numbers: | 07-020 |
Study First Received: | May 2, 2007 |
Last Updated: | May 3, 2007 |
ClinicalTrials.gov Identifier: | NCT00469742 History of Changes |
Health Authority: | United States: Institutional Review Board |
Cardiology Pediatrics Cardiac Defects Cardiopulmonary Bypass Surgery |
Aprotinin thrombosis renal dysfunction |
Serine Proteinase Inhibitors Hemostatics Thrombosis Protease Inhibitors Aprotinin |
Serine Proteinase Inhibitors Coagulants Molecular Mechanisms of Pharmacological Action Therapeutic Uses Hematologic Agents Trypsin Inhibitors |
Enzyme Inhibitors Hemostatics Pharmacologic Actions Protease Inhibitors Aprotinin |