Tranexamic Acid Reduces Bleeding After Cardiopulmonary Bypass When Compared to Epsilon Aminocaproic Acid and Placebo
| Autor: | Dan J. Kennedy, Scott B. Kribbs, Jodie Ecklund, Mark L. Pinosky, Robert Crawford, John M. Kratz, Francis G. Spinale, Scott Reeves, Glenn P. Gravlee, Richard L. Fishman, B.Hugh Dorman, Calvert C. Alpert |
|---|---|
| Rok vydání: | 1997 |
| Předmět: |
Male
Pulmonary and Respiratory Medicine Time Factors Antifibrinolytic medicine.drug_class medicine.medical_treatment Blood Loss Surgical Postoperative Hemorrhage Loading dose law.invention Double-Blind Method law Blood product Antifibrinolytic agent medicine Cardiopulmonary bypass Humans Prospective Studies Blood Coagulation Saline Blood Volume Cardiopulmonary Bypass business.industry Perioperative Middle Aged Antifibrinolytic Agents Tranexamic Acid Anesthesia Aminocaproic Acid Female Surgery Blood Coagulation Tests Cardiology and Cardiovascular Medicine business Tranexamic acid medicine.drug |
| Zdroj: | Journal of Cardiac Surgery. 12:330-338 |
| ISSN: | 1540-8191 0886-0440 |
| DOI: | 10.1111/j.1540-8191.1997.tb00147.x |
| Popis: | UNLABELLED Perioperative bleeding following coronary artery bypass grafting (CABG) is associated with increased blood product usage. Although aprotonin is effective in reducing perioperative blood loss, excessive cost prohibits routine utilization. Epsilon aminocaproic acid (EACA) and tranexamic acid (TA) are inexpensive antifibrinolytic agents, which, when given prophylactically, may reduce blood loss. The present study was undertaken to compare the efficacy of TA and EACA in reducing perioperative blood loss. METHODS The study population consisted of first-time CABG patients. Patients were allocated in a prospective double-blind fashion: (1) group EACA (loading dose 15 mg/kg, continuous infusion 10 mg/kg per hour for 6 hours, N = 20); (2) group TA (loading dose 15 mg/kg, continuous infusion 1 mg/kg per hour for 6 hours, N = 20); (3) control group (infusion of normal saline for 6 hours, N = 19). RESULTS Treatment groups were similar preoperatively. No significant difference in intraoperative blood loss or perioperative use of blood products was noted. D-dimer concentration was elevated in the control group compared to the EACA and TA groups (p < 0.05). Group TA had less postoperative blood loss than the EACA and control groups at 6 and 12 hours postoperatively (p < 0.05). TA had reduced total blood loss (600 +/- 49 mL) postoperatively compared to EACA (961 +/- 148 mL) and control (1060 +/- 127 mL, p < 0.05). CONCLUSION TA and EACA effectively inhibited fibrinolytic activity intraoperatively and throughout the first 24 hours postoperatively. TA was more effective in reducing blood loss postoperatively following CABG. This suggests that TA may be beneficial as an effective and inexpensive antifibrinolytic in first-time CABG patients. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|