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Effect of topical tranexamic acid in open heart surgery

Published online by Cambridge University Press:  27 January 2006

A. Abul-Azm  and
K. M. Abdullah
A. Abul-Azm
Affiliation:
Cairo University, Kasr El Ainy Faculty of Medicine, Department of Cardiothoracic Surgery, Cairo, Egypt
K. M. Abdullah
Affiliation:
Ain Shams University, Faculty of Medicine, Department of Anaesthesiology, Cairo, Egypt
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Abstract

Summary

Background and objective: Cardiopulmonary bypass is known to induce postoperative coagulopathy including fibrinolysis. We have evaluated the effect of the topical use of tranexamic acid in the pericardial cavity on postoperative bleeding following open heart surgery. Methods: One hundred patients, scheduled for elective open heart surgery, were included in this double-blind, prospective, randomized, controlled study. They were allocated to a treatment group (Group I), or placebo group (Group II). Patients with coagulopathies, renal failure, re-do surgery, or recent anti-platelet treatment were excluded. In Group I, tranexamic acid (2 g in 100 mL of saline solution) was poured into the pericardial cavity before sternal closure. Placebo patients received 100 mL of saline. Postoperative blood loss, need for transfusion of blood products and the rate of re-sternotomy for bleeding were documented. Results: During the first postoperative 24 h, cumulative blood loss was significantly higher in Group II compared to Group I (1208 ± 121 mL vs. 733 ± 93 mL, respectively) (P < 0.001). More blood transfusions were administered to Group II patients (4.54 ± 1.4 units) as compared to Group I patients (2.64 ± 1.5 units) (P < 0.01). Conclusion: Topical application of tranexamic acid in patients undergoing primary open heart surgery led to a significant reduction of both postoperative mediastinal bleeding, and rate of re-exploration for haemostasis.

Keywords

CRITICAL CARECARDIOPULMONARY BYPASS, TRANEXAMIC ACIDANTIFIBRINOLYTIC AGENTSPOSTOPERATIVE HAEMORRHAGECARDIAC SURGICAL PROCEDURES
Type
EACTA Original Article
Information
European Journal of Anaesthesiology , Volume 23 , Issue 5 , May 2006 , pp. 380 - 384
Copyright
2006 European Society of Anaesthesiology

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