Blood-saving Effect of Tranexamic Acid in Congenital Heart Disease of Adult_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

 SHOUXiao-mei , YULiu-lin

Department of Cardiovascular Surgery, the First Hospital of Lanzhou University, Lanzhou 730000, P. R. China;

Corresponding?author：

Keywords：

Tranexamic acid; Adult congenital heart patients; Blood conservation

DOI：

10.7507/1007-4848.20160268

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Objective To evaluate the blood protective effect of tranexamic acid on cardiopulmonary bypass in adult congenital heart disease patients. Methods There were 84 patients (37 males, 47 females) with congenital heart disease under-going extracorporeal circulation, aged from 18 to 50 years in iur hospital from June through December 2015. All patients were divided into two groups include a control group (group A) with 35 patients and a tranexamic acid group (group B) with 49 patients. After induction of anesthesia, the group B was given tranexamic acid 1 g, and then at rate of 400 mg/h continuous infusion till the end of operation. The group A was given equal volume of physiological saline. Before and after operation and withdrawing of the drainage, the levels of hemoglobin (Hb), platelet (PLt) and international normalized ratio (INR) were tested by taking the central venous blood samples. Chest tube drainage volume, use of red blood cells and plasma after opera-tion were recorded. Results No statistical difference was found between the two groups in Hb, PLT, or INR before opera-tion and usage of blood after operation (P>0.05). Compared with the group A, postoperative chest tube drainage, the use of plasma were lower (P<0.05) in the group B. There was a statistical difference between two groups in Hb, PLT, INR after operation, and withdrawing of the drainage (P<0.05), respectively, while no statistical difference in PLT at withdrawing of drainage was foud. No in-hospital mortality or postoperative complication occurred. Conclusion Tranexamic acid has protective effest on blood in adult patients with congenital heart disease undergoing cardiac surgery under cardiopulmonary bypass.

Citation： SHOUXiao-mei, YULiu-lin. Blood-saving Effect of Tranexamic Acid in Congenital Heart Disease of Adult. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2016, 23(12): 1139-1141. doi: 10.7507/1007-4848.20160268 Copy

1.	Hodgson S, Larvin JT, Dearman C. What dose of tranexamic acid is most effective and safe for adult patients undergoing cardiac surgery? Interact Cardiovasc Thorac Surg, 2015, 21(3): 384-388.
2.	管玉龍, 龍村. 粘彈性凝血功能監測技術的應用及進展. 中國胸心血管外科臨床雜志, 2009, 16 (4): 300-303.
3.	Yavari M, Becker RC. Coagulation and fibrinolytic protein kinetics in cardiopulmonary bypass. J Thromb Thrombolysis, 2009, 27(1): 95-104.
4.	Slight RD, Nzewi O, McCleland DB, et al. Red cell transfusion in elective cardiac surgery patients: where do we go from here. Br J Anaesth, 2009, 102(3): 294-296.
5.	張振, 王武軍, 王振康. 法洛四聯癥患者圍手術期凝血功能的變化及意義. 中國胸心血管外科臨床雜志, 2009, 16(3): 244-245.
6.	Chauhan S. Comparison of tranexamic acid with aprotinin in pediatric cardiac surgery. Ann Card Anaesth, 2015, 18(1): 27-28.
7.	Walkden GJ, Verheyden V, Goudie R, et al. Increased perioperative mortality following aprotinin withdrawal: a real-world analysis of blood management strategies in adult cardiac surgery. Intensive Care Med, 2013, 39(10): 1808-1817.
8.	Ali Shah MU, Asghar MI, Siddiqi R, et al. Topical application of tranexamic acid reduces postoperative bleeding in open-heart surgery: myth or fact? J Coll Physicians Surg Pak, 2015, 25(3): 161-165.
9.	Ng WC, Jerath A, Wasowicz M. Tranexamic acid: a clinical review. Anaesthesiol Intensive Ther, 2015, 47(4): 339-350.
10.	吳俊峰, 鄧睿華, 張耀森, 等. 不同劑量氨甲環酸在體外循環心臟手術后減少失血作用的比較. 中國胸心血管外科臨床雜志, 2001, 8(4): 291.
11.	Ichikawa J, Kodaka M, Kitahara T, et al. The use of thromboelasto-metry and tranexamic acid reduces blood loss and transfusion requirements in cardiac surgery under cardiopulmonary bypass. Masui, 2015, 64(2): 131-138.
12.	Sanfilippo F, Astuto M, Maybauer MO. Effects and timing of tranexamic acid on transfusion requirements in patients undergoing cardiac surgery with cardiopulmonary bypass. Anesthesiology, 2014, 121(4): 902.
13.	Wang JJ, Chen GJ, Liu W, et al. Influence of different tranexamic acid administration methods during and after cardiac surgery on coagulation function and postoperative blood loss. Zhongguo Yixue Kexue Yuan Xuebao, 2013, 35(2): 145-149.
14.	Casati V, Della Valle P, Benussi S, et al. Effects of tranexamic acid on postoperative bleeding and related hematochemical variables in coronary surgery: Comparison between on-pump and off-pump techniques. J Thorac Cardiovasc Surg, 2004, 128(1): 83-91.

1. Hodgson S, Larvin JT, Dearman C. What dose of tranexamic acid is most effective and safe for adult patients undergoing cardiac surgery? Interact Cardiovasc Thorac Surg, 2015, 21(3): 384-388.
2. 管玉龍, 龍村. 粘彈性凝血功能監測技術的應用及進展. 中國胸心血管外科臨床雜志, 2009, 16 (4): 300-303.
3. Yavari M, Becker RC. Coagulation and fibrinolytic protein kinetics in cardiopulmonary bypass. J Thromb Thrombolysis, 2009, 27(1): 95-104.
4. Slight RD, Nzewi O, McCleland DB, et al. Red cell transfusion in elective cardiac surgery patients: where do we go from here. Br J Anaesth, 2009, 102(3): 294-296.
5. 張振, 王武軍, 王振康. 法洛四聯癥患者圍手術期凝血功能的變化及意義. 中國胸心血管外科臨床雜志, 2009, 16(3): 244-245.
6. Chauhan S. Comparison of tranexamic acid with aprotinin in pediatric cardiac surgery. Ann Card Anaesth, 2015, 18(1): 27-28.
7. Walkden GJ, Verheyden V, Goudie R, et al. Increased perioperative mortality following aprotinin withdrawal: a real-world analysis of blood management strategies in adult cardiac surgery. Intensive Care Med, 2013, 39(10): 1808-1817.
8. Ali Shah MU, Asghar MI, Siddiqi R, et al. Topical application of tranexamic acid reduces postoperative bleeding in open-heart surgery: myth or fact? J Coll Physicians Surg Pak, 2015, 25(3): 161-165.
9. Ng WC, Jerath A, Wasowicz M. Tranexamic acid: a clinical review. Anaesthesiol Intensive Ther, 2015, 47(4): 339-350.
10. 吳俊峰, 鄧睿華, 張耀森, 等. 不同劑量氨甲環酸在體外循環心臟手術后減少失血作用的比較. 中國胸心血管外科臨床雜志, 2001, 8(4): 291.
11. Ichikawa J, Kodaka M, Kitahara T, et al. The use of thromboelasto-metry and tranexamic acid reduces blood loss and transfusion requirements in cardiac surgery under cardiopulmonary bypass. Masui, 2015, 64(2): 131-138.
12. Sanfilippo F, Astuto M, Maybauer MO. Effects and timing of tranexamic acid on transfusion requirements in patients undergoing cardiac surgery with cardiopulmonary bypass. Anesthesiology, 2014, 121(4): 902.
13. Wang JJ, Chen GJ, Liu W, et al. Influence of different tranexamic acid administration methods during and after cardiac surgery on coagulation function and postoperative blood loss. Zhongguo Yixue Kexue Yuan Xuebao, 2013, 35(2): 145-149.
14. Casati V, Della Valle P, Benussi S, et al. Effects of tranexamic acid on postoperative bleeding and related hematochemical variables in coronary surgery: Comparison between on-pump and off-pump techniques. J Thorac Cardiovasc Surg, 2004, 128(1): 83-91.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Blood-saving Effect of Tranexamic Acid in Congenital Heart Disease of Adult

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