Evaluation of Epsilon amino-caproic acid (EACA) and autologous blood as blood conservation strategies in patients undergoing cardiac surgery.
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.
Sharma
Vishal
V
Cardiothoracic Centre, All India Institute of Medical Sciences, New Delhi, India. vishalctva@hotmail.com
Talwar
Sachin
S
Choudhary
Shiv Kumar
SK
Lakshmy
Rama
R
Kale
Shailaja
S
Kumar
Arkalgud Sampath
AS
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*
D000933:Antifibrinolytic Agents; D015119:Aminocaproic Acid