Aminocaproic acid administration is associated with reduced perioperative blood loss and transfusion in pediatric craniofacial surgery
| Autor: | John E. Fiadjoe, E. Y. Pruitt, G. Hsu, A. M. Vincent, Jesse A. Taylor, Scott P. Bartlett, Paul A. Stricker |
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| Rok vydání: | 2015 |
| Předmět: |
Male
medicine.medical_specialty Blood transfusion Antifibrinolytic medicine.drug_class medicine.medical_treatment Blood Loss Surgical 03 medical and health sciences 0302 clinical medicine 030202 anesthesiology Interquartile range Antifibrinolytic agent Humans Medicine Blood Transfusion Craniofacial Craniofacial surgery Retrospective Studies business.industry Infant Newborn Infant General Medicine Perioperative Plastic Surgery Procedures Antifibrinolytic Agents Surgery Anesthesiology and Pain Medicine Child Preschool Anesthesia Aminocaproic Acid Female business Craniotomy 030217 neurology & neurosurgery Tranexamic acid medicine.drug |
| Zdroj: | Acta Anaesthesiologica Scandinavica. 60:158-165 |
| ISSN: | 0001-5172 |
| DOI: | 10.1111/aas.12608 |
| Popis: | Background Severe blood loss is a common complication of craniofacial reconstruction surgery. The antifibrinolytic e-aminocaproic acid (EACA) reduces transfusion requirements in children undergoing cardiac surgery and in older children undergoing spine surgery. Tranexamic acid (TXA), another antifibrinolytic with a similar mechanism of action, has been shown to reduce blood loss and transfusion requirements in children undergoing craniofacial surgery. However, TXA has been associated with an increase in post-operative seizures and is more expensive than EACA. There is currently little published data evaluating the efficacy of EACA in children undergoing craniofacial surgery. Methods This is a retrospective study of prospectively collected data from our craniofacial perioperative registries for children under 6 years of age who underwent anterior or posterior cranial vault reconstruction. We compared calculated blood loss, blood donor exposures, and post-operative drain output between subjects who received EACA and those who did not. Results The registry queries returned data from 152 subjects. Eighty-six did not receive EACA and 66 received EACA. The EACA group had significantly lower calculated blood loss (82 ± 43 vs. 106 ± 63 ml/kg, P = 0.01), fewer intraoperative blood donor exposures (median 2, interquartile range 1-2 vs. median 2, interquartile range 1-3; P = 0.02) and lower surgical drain output in the first post-operative 24 h (28 ml/kg vs. 37 ml/kg, P = 0.001) than the non-EACA group. Conclusion In this analysis of prospectively captured observational data, EACA administration was associated with less calculated blood loss, intraoperative blood donor exposures, and post-operative surgical drain output. |
| Databáze: | OpenAIRE |
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