The Edinburgh Experience — Low-dose Trasylol

Abstract

At the beginning of 1988, preservative-free Trasylol was not available for our patients in Edinburgh. We were able to use a preparation which contained as a preservative benzyl alcohol 9 mg/ml. Concerned about its toxic effects, we consulted the literature and came up with a dosage scheme of 1 mega KIU given over 30 min prior to initiating bypass, and 1.5 mega KIU administered over the first 1.5 h of bypass. This produces a total dose of aproximately half the amount used in the series of Royston et al. [1], Van Oeveren et al. [2] and Bidstrup et al. [3]. The drug was administered to a variety of patients who presented for cardiopulmonary bypass and we are reporting the results of those patients who had repeat cardiopulmonary bypass procedures performed through median sternotomies. As a control group, we have used consecutive patients having repeat cardiopulmonary bypass procedures through median sternotomies in 1987. Patients with a major surgical cause of bleeding confirmed at re-operation were excluded from the analysis. There were 27 patients in the Trasylol group and 24 in the control group. There were no differences in respect of age, sex, bypass time or type of operation. These details are summarised in Table 1.