Uso profilatico do acido tranexamico em cirurgia cardiaca realizada com auxilio da circulação extracorporea

AUTOR(ES)
DATA DE PUBLICAÇÃO

2000

RESUMO

Bleeding complications, as well as complications related to blood transfusions may impair the results of any kind of surgery, especially cardiac surgery. Cardiopulmonary bypass appears as responsible for major hemostatic dysfunctions that happen during cardiac surgery. These dysfunctions are related mostly to platelet function or fibrinolisis and strategies should be developed to prevent or treat these dysfunctions. In the literature there are some papers showing the efficacy of antifibrinolitic agents like aprotinin and tranexamic acid. For this purpose, Aprotinin is very efficient but expensive and can induce anaphylactic reactions. Tranexamic acid is cheaper out the best re-gimen of administration is still controversial. We have undertaken arandomized study to examine prophylactic administration of~tranexamic acid (Transamin) in eighty patients submi tted to primary coronary artery bypass graft operation with cardiopulmonary bypass. In one group, 39 patients recei ved 4g of tranexamic acid di vided in 2 hal ves: the first half given before sternotomy and the other half in the priming of the cardiopulmonary bypass circuito The other group of 41 patients was used as contraIs and received only saline solution (placebo). Both groups were comparable in alI demographic variables. The tranexamic acid group had asignificantly higher number of distal anastomoses. Our results, showed that tranexamic acid group bled 30% less than the placebo group (p=O, 013). However we could not find significant reduction in use of blood products ar in the number of transfused patients. Analyzing the complications (such as myocardial infarction, renal failure ar stroke) we also could not find any statistical difference, between both groups. In conclusion, 4gof the tranexamic acid given prophylacticly reduced postoperative bleeding after primary coronary artery bypass operation without increasing the rate of complications

ASSUNTO(S)

sangue - coagulação fibrinolise sangue - disturbios da coagulação

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