The effect of tranexamic acid in reducing postoperative hemorrhage in patients undergoing coronary artery bypass graft

• Main Authors: Alireza Rostami, Amin Haj Hoseini, Alireza Kamali
• Format: Article
• Language: English
• Published: Wolters Kluwer Medknow Publications 2020-01-01
• Series: Saudi Journal of Anaesthesia
• Subjects: anti-fiberinolytic; local tranexamic acid; prophylaxis
• Online Access: http://www.saudija.org/article.asp?issn=1658-354X;year=2020;volume=14;issue=4;spage=431;epage=435;aulast=Rostami

Introduction: Nowadays, cardiovascular diseases such as coronary heart disease are one of the most important causes of human mortality worldwide. Coronary artery bypass graft (CABG) surgery is a standard therapy approach for those suffering from coronary artery disease. Tranexamic acid (TXA), an antifibrinolytic drug, which, in turn, inhibits fibrinolysis, leading to the prevention of bleeding, thus, the present study aimed to evaluate the effect of topical TXA on bleeding reduction after coronary artery CABG. Materials and Methods: In this study 62 patients were randomly divided into two groups of TXA and control. After surgery and removal from the cardiopulmonary pump, TXA (2 g) was injected locally into the mediastinum by the surgeon. In the second group (control) the same amount of normal saline (100 cc) was given. Data were analyzed by SPSS 19 software via the t-test and Fisher's test. Results: A significant difference was found between the 2 groups in terms of postoperative hemorrhage, packed cell volume, platelet transfusion, duration of surgery, and received FFP (P = 0.0001; P = 0.01; P = 0.0001; P = 0.0001; P = 0.0001), where were found to be lower in the TXA group than in the placebo group. There was no significant difference in age, sex, return to the operating room, and discharge. Conclusion: The use of topical TXA in GABC significantly reduced postoperative hemorrhage, packed cell volume, platelet> transfusion, and FFP after surgery. Besides, it had no significant effect on the return to the operating room and mortality.