RANDOMIZED BLINDED STUDY OF APROTININ INFUSION FOR LIVER CRUSH INJURIES IN THE PIG MODEL

Repeat exploratory laparotomies for intra-abdominal bleeding in patien ts who sustain severe blunt intra-abdominal trauma are common. Reexplo ration usually reveals no single site of bleeding and the abdomen is c losed with laparotomy pad packing, with a presumed diagnosis of coagul opathy. These postoperative coagulational defects may be the result of dilution, consumption, dysfunction, or acquired defects of either the coagulation, fibrinolytic, or platelet systems. The liver plays a maj or role in the balance of hemostatic systems, and this balance is disr upted by liver trauma. This study investigates the use of intravenous aprotinin, a naturally occurring serine protease inhibitor, in a pig l iver crush model to evaluate its effectiveness in reducing intra-abdom inal bleeding in experimentally induced shock and non-shock states.