Tehran University Medical Journal (Nov 2003)
Comparison Of Effects Of Autotransfusion And Tranexamic Acid On Post Cardiopulmonary Bypass Bleeding
Abstract
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."nMaterials and Methods: In a prospective, randomized study, 200 patients undergoing CABG allocated into two groups:"n□ AT group = 100 patients received 1-2 units (300-450cc) autologous blood after"ntermination of CPB"nD TX group = 100 patients received tranexamic acid, 15mg/kg before the injection"nof heparin and 15mg/kg after protamin injection"nPostoperative bleeding, transfusions, complications, ICU stay and hospital stay were recorded."nResults: 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."nConclusion: 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."n"n"n
