Does tranexamic acid reduce blood loss in off-pump coronary artery bypass?
The hemostatic effect of tranexamic acid on the bleeding tendency and transfusion requirements in patients undergoing off-pump coronary artery bypass surgery was assessed in a prospective randomized double-blind study. Of 66 patients undergoing elective operations, 33 were given tranexamic acid (15 mg x kg(-1) before infusion of heparin and 15 mg x kg(-1) after protamine infusion), and the other 33 received only saline. Postoperative bleeding, transfusions, complications, hematological variables, and plasma D-dimer levels were recorded. Postoperative blood loss was significantly less in the tranexamic acid group compared to the control group (320 +/- 38 vs 480 +/- 75 mL). Patients in the tranexamic acid group received significantly less allogeneic blood products (0.46 vs 0.94 units per patient), and they had lower postoperative D-dimer levels. No postoperative thrombotic complications were observed in either group. Although off-pump coronary artery bypass surgery is associated with reduced frequency of hemorrhagic disorders, defective hemostasis still occurs, and tranexamic acid effectively reduces postoperative blood loss and the need for allogeneic blood products.
Department of Anesthesiology, Shariati Hospital, Tehran, Iran. amehraein@yahoo.com
Aflatoon
A
Mehr-Aein
Mostafa
M
Sadeghi
Manouchehr
M
Madani-civi
D000328:Adult; D000933:Antifibrinolytic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D001777:Blood Coagulation / Q000187:drug effects*; D001803:Blood Transfusion; D047549:Coronary Artery Bypass, Off-Pump / Q000009:adverse effects*; D004311:Double-Blind Method; D004334:Drug Administration Schedule; D005260:Female; D005338:Fibrin Fibrinogen Degradation Products / Q000378:metabolism; D006489:Hemostatic Techniques; D006801:Humans; D008297:Male; D019106:Postoperative Hemorrhage / Q000097:blood / Q000209:etiology / Q000517:prevention & control*; D011446:Prospective Studies; D013997:Time Factors; D014148:Tranexamic Acid / Q000008:administration & dosage / Q000627:therapeutic use*; D016896:Treatment Outcome
D000933:Antifibrinolytic Agents; D005338:Fibrin Fibrinogen Degradation Products; C036309:fibrin fragment D; D014148:Tranexamic Acid