[Comparison of the effects of epsilon-aminocaproic acid and aprotinin on intra- and postoperative bleeding in heart surgery].
Excessive bleeding during and after cardiac surgery with cardiopulmonary bypass is a real problem in this kind of surgery. The use of prophylactic high doses of aprotinin (APROT) reduces blood loss in this context but this treatment is expensive. Some investigators have advocated that epsilon-aminocaproic acid (EACA), a cheaper antifibrinolytic drug, could reduce blood loss in cardiac surgery. The goal of this prospective study was to determine if EACA is as effective as APROT for this clinical condition. Sixty patients undergoing elective surgery for cardiac disease were randomly allocated to one of the two groups. Drugs were administered after induction of anesthesia at a dose of 2.10(6) UIK in the APROT group or 5 g in the EACA group. The same dose was added to the priming of the cardiopulmonary bypass circuit. Until the skin closure the patients received 5.10(5) UIK/h of APROT or 2 g/h of EACA. Bleeding during and after surgery was not different between the two groups. No complication, directly due to the treatment administered, was observed. EACA seems to be as effective as APROT to reduce intra and post cardiac surgery blood loss. EACA has the advantage of being cheaper (treatment is approximately 200 times cheaper), therefore allowing a wider use.
Trinh-Duc
P
P
Département d'Anesthésie-Réanimation B, Hôpital Saint-Eloi, Montpellier.
Wintrebert
P
P
Boulfroy
D
D
Albat
B
B
Thévenet
A
A
Roquefeuil
B
B
D015119:Aminocaproic Acid / Q000627:therapeutic use*; D007611:Aprotinin / Q000627:therapeutic use*; D016063:Blood Loss, Surgical / Q000517:prevention & control*; D001026:Coronary Artery Bypass / Q000379:methods; D005260:Female; D006344:Heart Septal Defects, Atrial / Q000601:surgery; D006349:Heart Valve Diseases / Q000601:surgery; D006801:Humans; D007430:Intraoperative Care; D008297:Male; D008875:Middle Aged; D009204:Myocardial Revascularization / Q000379:methods; D011182:Postoperative Care; D011446:Prospective Studies
D007611:Aprotinin; D015119:Aminocaproic Acid
Comparaison des effets de l'acide epsilon-aminocaproïque et de l'aprotinine sur le saignement per- et post-opératoire en chirurgie cardiaque.