Tranexamic acid reduces blood loss in off-pump coronary artery bypass surgery

Reza Jalaeian Taghaddomi, Asadollah Mirzaee, Alireza Sharifian Attar, Abbas Shirdel
Journal of Cardiothoracic and Vascular Anesthesia 2009, 23 (3): 312-5

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 Eight patients were withdrawn, and 100 patients were divided into 2 groups.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.

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