title: Evaluation of Epsilon amino-caproic acid (EACA) and autologous blood as blood conservation strategies in patients undergoing cardiac surgery.
abstract: BACKGROUND
  To evaluate the effects of autologous blood and Epsilon amino-caproic acid on intra-operative and post-operative blood loss and homologous blood product requirements in patients undergoing cardiac surgery.
  
  
  METHODS
  Patients were randomly allocated to two groups of 30 each. In the Epsilon amino-caproic acid (EACA) group, the drug was administered in a loading dose of 100 mg/kg before skin incision followed by an infusion of 1/5 th the loading dose hourly and terminated 3 h after heparin neutralization. In the autologous transfusion (AT) group, 10% of the calculated whole blood volume was collected intra-operatively before cardiopulmonary bypass and re-infused after its termination.
  
  
  RESULTS
  Haemoglobin values were comparable pre-operatively, on cardiopulmonary bypass, off cardiopulmonary bypass and post-operatively on day two in both groups. Intra-operative blood loss was not significantly different (643.3+/-129.14 ml in group EACA versus 710+/-145.5 ml in group AT, p = 0.66). Although the chest drainage was more in group AT during 0-3 h (71.3+/-54.3 ml versus 112.6+/-79.3.6 ml, p = 0.006) it was comparable amongst in the first 24 h (231.1+/-98.3 ml in group AT versus 235+/-101.4 ml in group EACA, p = 0.88). Homologous blood product requirements were similar in both groups.
  
  
  CONCLUSIONS
  Autologous blood is as efficacious as Epsilon amino-caproic acid for blood conservation in cardiac surgery.
authors.affiliation: Cardiothoracic Centre, All India Institute of Medical Sciences, New Delhi, India. vishalctva@hotmail.com
authors.forename: Vishal
authors.initials: V
authors.lastname: Sharma
authors.forename: Sachin
authors.initials: S
authors.lastname: Talwar
authors.forename: Shiv Kumar
authors.initials: SK
authors.lastname: Choudhary
authors.forename: Rama
authors.initials: R
authors.lastname: Lakshmy
authors.forename: Shailaja
authors.initials: S
authors.lastname: Kale
authors.forename: Arkalgud Sampath
authors.initials: AS
authors.lastname: Kumar
mesh_terms: D000328:Adult; D015119:Aminocaproic Acid / Q000627:therapeutic use*; D000933:Antifibrinolytic Agents / Q000627:therapeutic use*; D016063:Blood Loss, Surgical / Q000503:physiopathology / Q000517:prevention & control*; D001804:Blood Transfusion, Autologous; D001810:Blood Volume / Q000502:physiology; D006348:Cardiac Surgical Procedures; D002315:Cardiopulmonary Bypass / Q000379:methods; D005260:Female; D006488:Hemostasis, Surgical / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019106:Postoperative Hemorrhage / Q000503:physiopathology / Q000517:prevention & control*
chemical_list: D000933:Antifibrinolytic Agents; D015119:Aminocaproic Acid