title: Comparison of different doses of ε-aminocaproic acid in children for tetralogy of Fallot surgery: clinical efficacy and safety.
abstract: OBJECTIVE
  The purpose of this study was to compare 2 different doses of ε-aminocaproic acid (EACA) and assess their relative efficacy and safety in children undergoing corrective surgery for tetralogy of Fallot (TOF).
  
  
  METHODS
  A prospective, randomized, controlled study.
  
  
  METHODS
  A tertiary care center.
  
  
  METHODS
  One hundred twenty children undergoing corrective surgery for TOF using cardiopulmonary bypass (CPB).
  
  
  METHODS
  Group 1 received 100 mg/kg of EACA after induction, upon initiation of CPB, and after protamine. Group 2 received 75 mg/kg of EACA after induction, followed by a maintenance infusion of 75 mg/kg/h until chest closure, and an additional 75 mg/kg upon initiation of CPB. Group 3 did not receive any antifibrinolytic agent or placebo.
  
  
  RESULTS
  Cumulative mean blood loss, total packed red blood cells, and fresh frozen plasma requirements were significantly less in group 2 (p ≤ 0.01). There were no significant differences in the total platelet concentrate transfused, re-exploration rate, incidence of renal failure, arrhythmias, neurologic complications, mortality, or length of intensive care unit stay among the 3 groups. The incidences of perioperative ST/T changes and chest closure time were significantly less in group 1 and group 2 (p ≤ 0.01). The duration of mechanical ventilation was significantly less in group 2 (p ≤ 0.01).
  
  
  CONCLUSIONS
  EACA was effective in reducing the postoperative blood loss and transfusion requirements in children undergoing corrective cardiac surgery on CPB for TOF. The dose regimen of 75 mg/kg after induction, followed by a maintenance infusion of 75 mg/kg/h until chest closure, and an additional 75 mg/kg upon initiation of CPB were more effective.
authors.affiliation: Department of Cardiac Anaesthesia, Cardiothoracic Centre, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Anju
authors.initials: A
authors.lastname: Sarupria
authors.forename: Neeti
authors.initials: N
authors.lastname: Makhija
authors.forename: Ramakrishnan
authors.initials: R
authors.lastname: Lakshmy
authors.forename: Usha
authors.initials: U
authors.lastname: Kiran
mesh_terms: D015119:Aminocaproic Acid / Q000008:administration & dosage* / Q000009:adverse effects; D000933:Antifibrinolytic Agents / Q000008:administration & dosage* / Q000009:adverse effects; D006348:Cardiac Surgical Procedures / Q000009:adverse effects*; D002675:Child, Preschool; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D009422:Nervous System Diseases / Q000139:chemically induced / Q000453:epidemiology; D019106:Postoperative Hemorrhage / Q000453:epidemiology / Q000517:prevention & control*; D011446:Prospective Studies; D013771:Tetralogy of Fallot / Q000453:epidemiology / Q000601:surgery*; D016896:Treatment Outcome
chemical_list: D000933:Antifibrinolytic Agents; D015119:Aminocaproic Acid