title: Tranexamic acid reduces blood transfusions in elderly patients undergoing combined aortic valve and coronary artery bypass graft surgery: a randomized controlled trial.
abstract: OBJECTIVE
  To evaluate the effects of tranexamic acid on postoperative blood loss and transfusion requirements in elderly patients undergoing combined aortic valve replacement and coronary artery bypass graft surgery (CABG).
  
  
  METHODS
  A prospective, randomized, double-blinded, placebo-controlled, parallel-group trial.
  
  
  METHODS
  A university hospital (single institution).
  
  
  METHODS
  Sixty-four patients 70 years or older undergoing combined aortic valve replacement and CABG surgery were included. One patient was withdrawn from the study after randomization by the attending surgeon because of a change in the surgical procedure. The remaining 63 patients were analyzed as intention to treat.
  
  
  METHODS
  The included patients were randomized to treatment with either tranexamic acid, 10 mg/kg, as a bolus injection before surgery followed by 1 mg/kg/h as an infusion during surgery, or a corresponding volume of 0.9% sodium chloride.
  
  
  RESULTS
  Postoperative blood loss was recorded for 16 hours. The transfusion of blood products was recorded during the entire hospital stay. The number of packed red cell transfusions given to the patients was significantly lower in the tranexamic acid group compared with the placebo group (median, 3.0 [interquartile range, 2-5] v 5.0 [3-7], p = 0.049).
  
  
  CONCLUSIONS
  Tranexamic acid reduced the number of packed red cell transfusions given to patients 70 years or older undergoing combined aortic valve replacement and CABG surgery.
authors.affiliation: Department of Cardiothoracic Anesthesia and Intensive Care, St Olav University Hospital, Trondheim, Norway. guri.greiff@gmail.com
authors.forename: Guri
authors.initials: G
authors.lastname: Greiff
authors.forename: Roar
authors.initials: R
authors.lastname: Stenseth
authors.forename: Alexander
authors.initials: A
authors.lastname: Wahba
authors.forename: Vibeke
authors.initials: V
authors.lastname: Videm
authors.forename: Stian
authors.initials: S
authors.lastname: Lydersen
authors.forename: Wenche
authors.initials: W
authors.lastname: Irgens
authors.forename: Lise
authors.initials: L
authors.lastname: Bjella
authors.forename: Hilde
authors.initials: H
authors.lastname: Pleym
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000933:Antifibrinolytic Agents / Q000627:therapeutic use; D001021:Aortic Valve / Q000473:pathology / Q000601:surgery*; D001803:Blood Transfusion / Q000706:statistics & numerical data*; D001026:Coronary Artery Bypass / Q000009:adverse effects*; D004311:Double-Blind Method; D005260:Female; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects*; D006801:Humans; D008297:Male; D019106:Postoperative Hemorrhage / Q000209:etiology / Q000517:prevention & control*; D011446:Prospective Studies; D014148:Tranexamic Acid / Q000627:therapeutic use*
chemical_list: D000933:Antifibrinolytic Agents; D014148:Tranexamic Acid