title: Tranexamic acid reduces blood loss after off-pump coronary surgery: a prospective, randomized, double-blind, placebo-controlled study.
abstract: BACKGROUND
  Bleeding and the need for allogeneic transfusions are still problems after off-pump coronary artery bypass grafting (OPCAB) surgery. We therefore evaluated the effects of an antifibrinolytic, tranexamic acid, on postoperative bleeding and transfusion requirements in patients undergoing OPCAB surgery.
  
  
  METHODS
  Two hundred thirty-one consecutive patients scheduled for elective OPCAB were enrolled in the study. Using a double-blind method, the patients were randomly assigned to receive either tranexamic acid (bolus 1 g before surgical incision followed by an infusion of 400 mg/h during surgery; n = 116) or a placebo (infusion equivalent volume of saline solution; n = 115). The primary outcome was 24-hour postoperative chest tube drainage. Allogeneic transfusion, mortality, major morbidities, and resource utilization were also recorded.
  
  
  RESULTS
  In comparison with the placebo group, the patients receiving tranexamic acid had a significant reduction in chest tube drainage at 6 hours (270 ± 118 mL vs 416 ± 179 mL, P < 0.001) and 24 hours (654 ± 224 mL vs 891 ± 295 mL, P < 0.001). There was also a significant reduction in allogeneic red blood cell transfusions (47 vs 31.9%, P = 0.019) and fresh frozen plasma (29.6% vs 17.2%, P = 0.027) transfusions. There were no differences in mortality, morbidity, and resource utilization between the 2 groups.
  
  
  CONCLUSIONS
  Tranexamic acid reduces postoperative chest tube drainage and the requirement for allogeneic transfusion in off-pump coronary surgery.
authors: Department of Anesthesiology, Fuwai Hospital and Cardiovascular Institute, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100037, China. guyanwang2006@163.com
authors: Guyan
authors: G
authors: Wang
authors: Gaoqiang
authors: G
authors: Xie
authors: Tingting
authors: T
authors: Jiang
authors: Yuefu
authors: Y
authors: Wang
authors: Weipeng
authors: W
authors: Wang
authors: Hongwen
authors: H
authors: Ji
authors: Mingzheng
authors: M
authors: Liu
authors: Lei
authors: L
authors: Chen
authors: Lihuan
authors: L
authors: Li
mesh_terms: D000368:Aged; D000933:Antifibrinolytic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D015505:Chest Tubes; D016009:Chi-Square Distribution; D002681:China; D047549:Coronary Artery Bypass, Off-Pump / Q000009:adverse effects* / Q000401:mortality; D003324:Coronary Artery Disease / Q000401:mortality / Q000601:surgery*; D004311:Double-Blind Method; D004322:Drainage / Q000295:instrumentation; D017558:Elective Surgical Procedures; D017707:Erythrocyte Transfusion; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010919:Placebos; D019106:Postoperative Hemorrhage / Q000209:etiology / Q000401:mortality / Q000517:prevention & control*; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D014148:Tranexamic Acid / Q000009:adverse effects / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D000933:Antifibrinolytic Agents; D010919:Placebos; D014148:Tranexamic Acid