Tranexamic Acid Administration During On-Pump Cardiac Surgery: A Survey of Current Practices Among Canadian Anesthetists Working in Academic Centers
| Autor: | Karen Raymer, Andre Lamy, Summer Syed, Antonella Tidy, Richard P. Whitlock, Jessica Spence, Steven Long, P. J. Devereaux |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
Male
medicine.medical_specialty Canada 030204 cardiovascular system & hematology 03 medical and health sciences 0302 clinical medicine 030202 anesthesiology Antifibrinolytic agent Surveys and Questionnaires medicine Humans Coronary Artery Bypass Academic Medical Centers business.industry Dosing regimen Antifibrinolytic Agents Cardiac surgery Observational Studies as Topic Anesthesiology and Pain Medicine Tranexamic Acid Current practice Anesthesia Anesthetists Female business Tranexamic acid medicine.drug |
| Zdroj: | Anesthesia and analgesia. 125(6) |
| ISSN: | 1526-7598 |
| Popis: | Tranexamic acid (TXA) is commonly administered during on-pump cardiac surgery to minimize bleeding. However, an optimal dosing regimen has not been described, and recent studies suggest that higher doses may be associated with seizure. Little is known about current practice among cardiac anesthetists.We contacted all academic anesthesia departments in Canada to identify cardiac anesthetists, who represent the majority of practitioners. This group constituted our sampling frame. Information regarding participant demographics, TXA dose, and administration details were obtained by electronic survey. Responses were analyzed descriptively. To compare dose, we assumed an 80-kg patient and 3 hours of infusion time. The Kruskal-Wallis test was used to compare average dose across provinces.Among 341 Canadian academic cardiac anesthetists, 234 completed the survey (68.2% response rate). Among respondents, 86.3% administer TXA to all patients; 13.7% administer it to some. Most (68.4%) administer an infusion after a bolus; other modes included infusion (4.7%), single bolus (13.2%), 2 or more boluses (12.0%), or another regimen (1.7%). The mean (standard deviation) dose given was 49 mg/kg (24), with a range from 10 to 100 mg/kg. The mean dose varied across provinces from 23 to 55 mg/kg (P = .001).TXA is given to nearly all patients undergoing on-pump cardiac surgery at academic hospitals in Canada. However, there is significant heterogeneity in practice between individuals and across provinces. Further research is needed to determine the TXA dose that maximizes efficacy and minimizes side effects. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|