Effects of tranexamic acid on postoperative bleeding and related hematochemical variables in coronary surgery: Comparison between on-pump and off-pump techniques

The Journal of Thoracic and Cardiovascular Surgery
V CasatiArmando D'Angelo

Abstract

Bleeding and inflammation are major complications of extracorporeal circulation. Off-pump coronary artery bypass grafting may reduce the rate of complications, but it can only be applied in selected cases. Pilot studies have shown a potential benefit from the use of antifibrinolytic drugs, but efficacy in randomized double-blind studies evaluating off- and on-pump coronary artery bypass grafting has not been proved. We enrolled 102 patients scheduled for on-pump (n = 51) or off-pump (n = 51) coronary artery bypass grafting. Patients were separately double-blind randomly assigned to treatment with tranexamic acid (1 g as 20-minute bolus before skin incision, followed by continuous infusion of 400 mg/h, with 500 mg added to priming in patients undergoing on-pump coronary artery bypass grafting) or placebo (saline solution of equivalent volume). Bleeding in the first 24 postoperative hours was the primary outcome. Requirement for allogeneic transfusions, thrombotic complications, outcomes, and monitoring of coagulation, fibrinolysis, and inflammation were also recorded. Tranexamic acid reduced total postoperative bleeding by 43% in patients undergoing on-pump coronary artery bypass grafting and by 27% in those undergoing off-pump ...Continue Reading

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Citations

Oct 16, 2007·Current Opinion in Hematology·Craig A UmscheidKendal Williams
May 23, 2012·BMJ : British Medical Journal·Katharine KerIan Roberts
Jan 18, 2005·Clinical Chemistry and Laboratory Medicine : CCLM·Marcela ZivkovićZeljko Sutlić
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Apr 13, 2006·Scandinavian Cardiovascular Journal : SCJ·Minxin WeiMatti Tarkka
Aug 29, 2006·The Journal of Thoracic and Cardiovascular Surgery·Valter CasatiArmando D'Angelo
Jan 26, 2006·The Journal of Thoracic and Cardiovascular Surgery·Domenico PaparellaStephanie J Brister
Feb 21, 2006·The Annals of Thoracic Surgery·Federico PappalardoArmando D'Angelo
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Jan 24, 2009·The Journal of Maternal-fetal & Neonatal Medicine : the Official Journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians·Leila SekhavatAtefah Dehghani Tafti
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Mar 20, 2008·Anesthesia and Analgesia·Michael P Eaton
Jan 7, 2017·Journal of Korean Neurosurgical Society·Ho Yong ChoiHyun-Jib Kim

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