Aprotinin is frequently given after pediatric cardiac surgery to control bleeding. The hypothesis of this study was that patients administered aprotinin in the intensive care unit after a cardiac operation would receive fewer transfusions during the first postoperative day than those who did not receive aprotinin. In this retrospective case-control study, 283 infants younger than 1 year who received high-dose aprotinin were paired to 283 similar patients who did not receive any aprotinin. No association was found between the prophylactic administration of aprotinin, blood product transfusions and short-term outcome. Patients with aprotinin prophylaxis received more rather than less plasma transfusions. There was almost no bleeding. The main limitation of this study is that there was no chance to find any difference. The threshold hemoglobin level was so high that almost all patients (99.6%) received red cell transfusions. Similarly, the threshold platelet count was very high and a very high proportion of patients (70.8%) received platelet transfusions. This study did not and could not show that aprotinin prevents blood product transfusions.

– Jacques Lacroix