Aprotinin is a serine protease inhibitor that is prepared from bovine lung and which inhibits fibrinolysis. Administration to patients during surgery can reduce bleeding and consequently blood transfusion needs. Cole et al used a protocol for children undergoing prolonged spinal surgery.


Aprotinin is given as an infusion through a central line. The dose is based on the patient's body surface area (BSA).



Loading Dose

Maintenance Dose

BSA <= 1 square meter

240 mg per square meter BSA

56 mg per square meter BSA per hour.

BSA > 1 square meter

280 mg (200 mL)

70 mg per hour (50 mL)


over the 30 minutes prior to making the initial incision

after the loading dose, during surgery and for 4 hours after surgery



• Aprotinin is supplied as a solution with 1.4 mg/mL, which provides 10,000 Kallikrein Inhibitor Units (KIU) per mL.

• In the administration of Trasylol (aprotinin injection) in the PDR it is recommended that a test dose of 1 mL be given 10 minutes prior to the loading dose to detect a possible allergic reaction.

• The dosage regimen is comparable to the high dose aprotinin regimen (see PDR).


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