Fatal Anaphylactic Shock After Aprotinin Reexposure in Cardiac Surgery

Abstract

Comment In this report of an anaphylactic response to readministration of aprotinin, the audiors caution that many institutions may have overestimated the benefits of aprotinin administration relative to its risks. Therefore, it is important to define appropriate criteria to limit aprotinin exposure. It is also important to be certain that aprotinin is properly administered. The manufacturer's package insert recommends that a 1-cc (10,000 KIU) dose be given 10 min before administering the loading infusion. Furthermore, it is recommended that the loading dose be given for 20 to 30 min. Hence, the rate of administration in this case report seems to have