Volume 61, Issue 6 (15 2003)
Tehran Univ Med J 2003, 61(6): 450-456 |
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Mehr Aein A, Davoodi S, Madani Givi M. Comparison Of Effects Of Autotransfusion And Tranexamic Acid On Post Cardiopulmonary Bypass Bleeding. Tehran Univ Med J 2003; 61 (6) :450-456
URL: http://tumj.tums.ac.ir/article-1-1153-en.html
URL: http://tumj.tums.ac.ir/article-1-1153-en.html
Comparison Of Effects Of Autotransfusion And Tranexamic Acid On Post Cardiopulmonary Bypass Bleeding
Abstract: (8695 Views)
The aim of this study was to compare the effects of intraoperative autotransfusion and tranexamic acid on post-operative bleeding and need for allogeneic transfusion.
Materials and Methods: In a prospective, randomized study, 200 patients undergoing CABG allocated into two groups:
□ AT group = 100 patients received 1-2 units (300-450cc) autologous blood after termination of CPB D TX group = 100 patients received tranexamic acid, 15mg/kg before the injection of heparin and 15mg/kg after protamin injection Postoperative bleeding, transfusions, complications, ICU stay and hospital stay were recorded.
Results: The postoperative bleeding was lower in TX group (600 ml) than in AT group (1100 ml) (P <0.001). The rates of transfused patients in AT and TX groups were 72% and 65%. Patients in the AT group received more whole blood (2.82 units per patient vs. 1.93 units in TX group) (P<0.01). The numbers of FFP units administered per patient in AT and TX groups were 3.08 and 2.38 (P <0.01). In TX group, ICU stays and hospital stays were 0.8, 5.4 days (vs. 1.2s, 6.7days in AT group). In AT group, there were 2 transient renal dysfunctions and two re-operations. There was no difference between all groups regarding to neurological dysfunction and coagulopathy. There is no hospital mortality in all groups.
Conclusion: Tranexamic acid in comparison with intra-operative autotransfusion effectively reduces postoperative complications and allogeneic transfusions in CABG. In addition this technique due to shorter ICU and hospital stay is cost- effective.
Materials and Methods: In a prospective, randomized study, 200 patients undergoing CABG allocated into two groups:
□ AT group = 100 patients received 1-2 units (300-450cc) autologous blood after termination of CPB D TX group = 100 patients received tranexamic acid, 15mg/kg before the injection of heparin and 15mg/kg after protamin injection Postoperative bleeding, transfusions, complications, ICU stay and hospital stay were recorded.
Results: The postoperative bleeding was lower in TX group (600 ml) than in AT group (1100 ml) (P <0.001). The rates of transfused patients in AT and TX groups were 72% and 65%. Patients in the AT group received more whole blood (2.82 units per patient vs. 1.93 units in TX group) (P<0.01). The numbers of FFP units administered per patient in AT and TX groups were 3.08 and 2.38 (P <0.01). In TX group, ICU stays and hospital stays were 0.8, 5.4 days (vs. 1.2s, 6.7days in AT group). In AT group, there were 2 transient renal dysfunctions and two re-operations. There was no difference between all groups regarding to neurological dysfunction and coagulopathy. There is no hospital mortality in all groups.
Conclusion: Tranexamic acid in comparison with intra-operative autotransfusion effectively reduces postoperative complications and allogeneic transfusions in CABG. In addition this technique due to shorter ICU and hospital stay is cost- effective.
Keywords: Autotransfusion, Postoperative bleeding
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