title: Comparison of blood-sparing efficacy of ε-aminocaproic acid and tranexamic acid in newborns undergoing cardiac surgery.
abstract: BACKGROUND
  ε-Aminocaproic acid (EACA) and tranexamic acid (TXA) are used for antifibrinolytic therapy in neonates undergoing cardiac surgery, although data directly comparing their blood-sparing efficacy are not yet available. We compared two consecutive cohorts of neonates for the effect of these two medications on perioperative blood loss and allogeneic transfusions.
  
  
  METHODS
  Data from the EACA group (n = 77) were collected over a 12-month period; data from the tranexamic acid group (n = 28) were collected over a 5-month period. Blood loss, rate of reoperation due to bleeding, and transfusion requirements were measured.
  
  
  RESULTS
  There was no significant difference in blood loss at 6 hours (EACA 24 [17-30] mL/kg [median (interquartile range)] vs. TXA 20 [11-34] mL/kg, P = 0.491), at 12 hours (EACA 31 [22-38] mL/kg vs. TXA 27 [19-43] ml/kg, P = 0.496) or at 24 hours postoperatively (EACA 41 [31-47] mL/kg vs. TXA 39 [27-60] mL/kg; P = 0.625) or transfusion of blood products.
  
  
  CONCLUSIONS
  ε-Aminocaproic acid and tranexamic acid are equally effective with respect to perioperative blood loss and transfusion requirements in newborns undergoing cardiac surgery.
authors.affiliation: Institute of Anesthesiology, German Heart Center Munich, Munich, Germany. martin@dhm.mhn.de
authors.forename: K
authors.initials: K
authors.lastname: Martin
authors.forename: R
authors.initials: R
authors.lastname: Gertler
authors.forename: A
authors.initials: A
authors.lastname: Sterner
authors.forename: M
authors.initials: M
authors.lastname: MacGuill
authors.forename: C
authors.initials: C
authors.lastname: Schreiber
authors.forename: J
authors.initials: J
authors.lastname: Hörer
authors.forename: M
authors.initials: M
authors.lastname: Vogt
authors.forename: P
authors.initials: P
authors.lastname: Tassani
authors.forename: G
authors.initials: G
authors.lastname: Wiesner
mesh_terms: D015119:Aminocaproic Acid / Q000627:therapeutic use*; D000933:Antifibrinolytic Agents / Q000627:therapeutic use*; D016063:Blood Loss, Surgical / Q000517:prevention & control*; D001803:Blood Transfusion / Q000706:statistics & numerical data; D006348:Cardiac Surgical Procedures / Q000009:adverse effects; D005260:Female; D005858:Germany; D006330:Heart Defects, Congenital / Q000097:blood / Q000601:surgery*; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D019106:Postoperative Hemorrhage / Q000517:prevention & control*; D011446:Prospective Studies; D013997:Time Factors; D014148:Tranexamic Acid / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D000933:Antifibrinolytic Agents; D014148:Tranexamic Acid; D015119:Aminocaproic Acid