Tranexamic Acid Reduces Blood Loss in Off-Pump Coronary Artery Bypass Surgery

• Published in: Journal of cardiothoracic and vascular anesthesia Vol. 23; no. 3; pp. 312 - 315
• Main Authors: Taghaddomi, Reza Jalaeian, MD, Mirzaee, Asadollah, MD, Attar, Alireza Sharifian, MD, Shirdel, Abbas, MD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.06.2009
• Subjects: Adult; Aged; Anesthesia & Perioperative Care; Blood Volume - drug effects; Blood Volume - physiology; Coronary Artery Bypass, Off-Pump - adverse effects; Critical Care; Double-Blind Method; Female; hemostasis; Humans; Male; Middle Aged; off-pump coronary artery bypass; Postoperative Hemorrhage - drug therapy; Postoperative Hemorrhage - etiology; Postoperative Hemorrhage - prevention & control; Prospective Studies; tranexamic acid; Tranexamic Acid - pharmacology; Tranexamic Acid - therapeutic use; off-pump coronary artery bypass; tranexamic acid; hemostasis
• ISSN: 1053-0770; 1532-8422
• DOI: 10.1053/j.jvca.2008.09.018

Objective This study was designed to evaluate the hemostatic effect of tranexamic acid in off-pump coronary artery bypass surgery. Design A prospective, randomized, double-blind, placebo-controlled study. Setting The Department of Anesthesiology and Cardiac Surgery, Medical Sciences University. Participants One hundred eight patients undergoing off-pump coronary artery bypass surgery were enrolled into the study. Eight patients were withdrawn, and 100 patients were divided into 2 groups. Interventions Fifty patients received tranexamic acid (bolus 1 g before skin incision and followed by maintenance dose of 400 mg/h during surgery), and 50 patients received saline. Measurement and Main Results Hematologic parameters, volume of blood loss, blood transfusion, and other clinical data were recorded throughout the perioperative period. Twenty-four-hour postoperative blood loss was significantly less in the tranexamic acid group compared with the control group (471 ± 182 v 844 ± 303). Patients in the tranexamic acid group received significantly less allogeneic blood (8 v 31 units). Conclusion Bleeding and hemorrhagic complications and the consequent need for allogeneic transfusion are still major problems after off-pump coronary artery bypass surgery. Tranexamic acid appears to be effective in reducing postoperative bleeding and the need for allogeneic blood products.