Comparison of trauma-dosed tranexamic acid versus aminocaproic acid in cardiac surgery in the setting of drug shortage.
J Card Surg
; 37(10): 3243-3249, 2022 Oct.
Article
de En
| MEDLINE
| ID: mdl-35870172
ABSTRACT
BACKGROUND:
Antifibrinolytic agents, tranexamic acid (TXA) and epsilon-aminocaproic acid (EACA), are often used during cardiac surgery to decrease the number of allogenic blood transfusions and to prevent perioperative bleeding. Weight-based TXA dosing regimens have been compared to fixed-dose regimens of EACA with variable outcomes in perioperative blood product transfusions and chest tube output. Serious adverse events, including seizures, have been reported with higher doses of TXA. Fixed-dose TXA regimens have been evaluated in trauma and orthopedic surgery but there is a paucity of evidence in the cardiac surgery population. AIMS OF THE STUDY To compare the safety and efficacy of fixed-dose TXA versus EACA in patients undergoing cardiac surgery.METHODS:
A single-center, retrospective chart review was conducted at a 793-bed tertiary care academic teaching hospital comparing cardiac surgery patients receiving either fixed-dose TXA 1000 mg followed by a 500-1000 mg infusion or EACA-7.5 g intravenous boluses followed by a 1-1.25 g/h infusion for the duration of the surgery. The major endpoint included chest tube output at 12 h, 24 h, and 7 days postoperatively. Minor endpoints included quantity and incidence of blood product transfusions and reported safety events.RESULTS:
There were 1544 patients included. Chest tube output was similar between groups and the TXA group required more intraoperative blood product transfusions (22.7% vs. 18.2%, p = .03). There were no differences in the median quantity of total blood products administered postoperatively at 24 h or at 7 days. Reported safety events were similar between groups.CONCLUSION:
Both fixed-dose TXA and EACA may be considered safe and effective options for antifibrinolytic therapy in cardiac surgery patients.Mots clés
Texte intégral:
1
Collection:
01-internacional
Base de données:
MEDLINE
Sujet principal:
Acide tranéxamique
/
Procédures de chirurgie cardiaque
/
Antifibrinolytiques
Type d'étude:
Observational_studies
/
Risk_factors_studies
Limites:
Humans
Langue:
En
Journal:
J Card Surg
Sujet du journal:
CARDIOLOGIA
Année:
2022
Type de document:
Article
Pays d'affiliation:
États-Unis d'Amérique