title: Tranexamic acid reduces blood loss after cardiopulmonary bypass.
abstract: To evaluate the effect of tranexamic acid (TA) on blood loss after cardiopulmonary bypass (CPB), 157 patients who underwent elective valve replacement operations were studied, with one group of 90 patients receiving tranexamic acid (Group TA) and 67 patients serving as the control group (Group N). In group TA, 50 mg/kg of tranexamic acid was administered just before and after CPB, and every 90 minutes during CPB. The activated coagulation time was maintained at more than 450 seconds during CPB in both groups. There was no significant difference in the CPB time between the groups (163 +/- 32 min in group N and 152 +/- 38 min in group TA:NS). The time required for hemostasis was shortened in group TA, which resulted in a shorter operation time (6.7 +/- 1.5 hrs vs 6.0 +/- 1.5 hrs in group N and group TA, respectively: p = 0.006). The amount of chest tube drainage within 12 hours after surgery was significantly reduced (225 +/- 129 ml vs. 180 +/- 118 ml in group N and group TA, respectively: p = 0.026). The chest tube was able to be removed earlier in group TA, and the total blood loss was significantly smaller in group TA (402 +/- 292 ml) than in group N (631 +/- 609 ml; p = 0.004). The authors thus conclude that antifibrinolytic therapy during CPB with tranexamic acid reduces postoperative blood loss, and shortens the operation time due to an improvement in hemostasis.
authors.affiliation: Division of Cardiovascular Surgery, Faculty of Medicine, Kyushu University, Fukuoka, Japan.
authors.forename: A
authors.initials: A
authors.lastname: Nakashima
authors.forename: K
authors.initials: K
authors.lastname: Matsuzaki
authors.forename: F
authors.initials: F
authors.lastname: Fukumura
authors.forename: M
authors.initials: M
authors.lastname: Hisahara
authors.forename: Y
authors.initials: Y
authors.lastname: Kanegae
authors.forename: K
authors.initials: K
authors.lastname: Fukae
authors.forename: K
authors.initials: K
authors.lastname: Miyamoto
authors.forename: T
authors.initials: T
authors.lastname: Nishida
authors.forename: S
authors.initials: S
authors.lastname: Tokunaga
authors.forename: R
authors.initials: R
authors.lastname: Tominaga
mesh_terms: D000328:Adult; D000368:Aged; D016063:Blood Loss, Surgical / Q000503:physiopathology / Q000517:prevention & control*; D002315:Cardiopulmonary Bypass; D005260:Female; D006349:Heart Valve Diseases / Q000097:blood / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010107:Oxygenators, Membrane; D011292:Premedication; D014148:Tranexamic Acid / Q000008:administration & dosage* / Q000009:adverse effects
chemical_list: D014148:Tranexamic Acid