Current antifibrinolytic therapy for coronary artery revascularization.
The use of antifibrinolytic therapy is commonplace in coronary artery revascularization procedures. Cardiac surgery accounts for more than 700,000 surgeries per year, with approximately 70% of these cases requiring antifibrinolytic therapy for coronary artery bypass graft (CABG) procedures. Two main classes of antifibrinolytics are used in CABG procedures: synthetic lysine analogues and serine protease inhibitors. Both classes of antifibrinolytics have been shown to decrease the incidence of blood transfusions. However, new data have emerged regarding an increase in adverse outcomes associated with serine protease inhibitors. The purpose of this review article is to describe the clinical significance of antifibrinolytic therapy and the current implications associated with its use.
Trudell
Jason
J
University of Pittsburgh School of Nursing, Nurse Anesthesia Program, Pennsylvania, USA. jasontrudell58@hotmail.com
McMurdy
Nicholas
N
D015119:Aminocaproic Acid / Q000627:therapeutic use; D000933:Antifibrinolytic Agents / Q000009:adverse effects* / Q000145:classification / Q000627:therapeutic use*; D007611:Aprotinin / Q000627:therapeutic use; D016063:Blood Loss, Surgical / Q000517:prevention & control; D001803:Blood Transfusion / Q000706:statistics & numerical data; D001026:Coronary Artery Bypass / Q000009:adverse effects / Q000379:methods / Q000706:statistics & numerical data; D006801:Humans; D008239:Lysine / Q000031:analogs & derivatives; D018579:Patient Selection; D019106:Postoperative Hemorrhage / Q000209:etiology / Q000517:prevention & control; D012307:Risk Factors; D017751:Safety Management; D015842:Serine Proteinase Inhibitors / Q000627:therapeutic use; D014148:Tranexamic Acid; D016896:Treatment Outcome
D000933:Antifibrinolytic Agents; D015842:Serine Proteinase Inhibitors; D014148:Tranexamic Acid; D007611:Aprotinin; D008239:Lysine; D015119:Aminocaproic Acid