A retrospective study of the effects of small-dose aprotinin on blood lossand transfusion needs during total hip arthroplasty

Aprotinin is a proteinase inhibitor that reduces blood loss in total hip ar throplasty when administered in large doses. Little is known about the capa bility of smaller doses of aprotinin in reducing blood loss and transfusion needs in this surgical setting. We reviewed the medical records of 372 pat ients who had undergone unilateral primary total hip arthroplasty under gen eral anaesthesia during a 6-year period (1989 to 1994) at our institution. Successively, 193 patients had and 179 patients had not received aprotinin in a dose of 20000 kallikrein inhibitor units per kilogram body weight intr avenously before surgery. Neither the volume of red blood cells lost nor th at of red blood cells transfused during hospitalization differed significan tly between the patients who had and those who had not received aprotinin ( 520 +/- 406 vs. 549 +/- 394 mL and 463 +/- 379 vs. 475 +/- 367 mL; P = 0.49 and P = 0.76 respectively). These results suggest that small-dose aprotini n was not effective in reducing blood loss and transfusion needs in patient s undergoing unilateral primary total hip replacement.