title: Tranexamic acid reduces postbypass blood use: a double-blinded, prospective, randomized study of 210 patients.
abstract: BACKGROUND
  Pharmacologic intervention to minimize postbypass bleeding and blood product transfusions has received increasing attention for both medical and economic reasons.
  
  
  METHODS
  Two hundred ten patients were entered into a double-blinded, prospective, randomized study to receive either 10 g of fibrinolytic inhibitor tranexamic acid before incision (n = 104) or 250 mL of placebo saline solution (n = 106). All subjects requiring cardiopulmonary bypass were deemed suitable, including those having first-time coronary bypass grafting, valve replacement, and reoperation.
  
  
  RESULTS
  There were no statistically significant differences between the groups with respect to demographic or operative characteristics. The tranexamic acid group had a 48% reduction in 24-hour blood drainage (p < 0.001) and received 69% fewer total units of packed red blood cells, 83% fewer total units of plasma, and 75% fewer platelet transfusion units than controls. Only 13 of 104 tranexamic acid patients received blood products versus 33 of 106 controls (p < 0.001). The incidences of thrombotic complications, perioperative myocardial infarction, renal failure, and neurologic complications were not significantly different between the two groups. The tranexamic acid group had 0% mortality versus 1.9% for controls (not significant).
  
  
  CONCLUSIONS
  Tranexamic acid is safe and effective in reducing blood loss and blood use in a wide variety of cardiac surgical patients.
authors.affiliation: Division of Cardiothoracic Surgery, Fairview Hospital, Cleveland, Ohio, 44111, USA.
authors.forename: D
authors.initials: D
authors.lastname: Katsaros
authors.forename: M
authors.initials: M
authors.lastname: Petricevic
authors.forename: N J
authors.initials: NJ
authors.lastname: Snow
authors.forename: D D
authors.initials: DD
authors.lastname: Woodhall
authors.forename: R
authors.initials: R
authors.lastname: Van Bergen
mesh_terms: D000368:Aged; D000933:Antifibrinolytic Agents / Q000627:therapeutic use*; D001803:Blood Transfusion / Q000706:statistics & numerical data; D002315:Cardiopulmonary Bypass / Q000401:mortality / Q000706:statistics & numerical data; D004311:Double-Blind Method; D005260:Female; D006470:Hemorrhage / Q000097:blood / Q000401:mortality / Q000517:prevention & control*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000097:blood / Q000401:mortality / Q000517:prevention & control*; D011446:Prospective Studies; D013997:Time Factors; D014148:Tranexamic Acid / Q000627:therapeutic use*
chemical_list: D000933:Antifibrinolytic Agents; D014148:Tranexamic Acid