Adverse Central Nervous System Outcomes After Cardiopulmonary Bypass: A Beneficial Effect of Aprotinin?

This review considers the evidence for potential central nervous system benefits associated with use of anti- protease therapy for patients undergoing procedures involving cardiopulmonary bypass. Unfortunately, few randomized, controlled clinical trials have assessed the lysine analogue class of antifibrinolytics (ie, ∈-amino caproic acid, tranexamic acid) compared with the num ber investigating the efficacy of the enzyme-inactivator class of antifibrinolytic typified by the nonspecific serine protease inhibitors aprotinin and nafamostat.