EVALUATION OF THE ROLE OF TRANEXAMIC ACID ADMINISTRATION IN CARDIO-PULMONARY BYPASS
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In this study 67 Patients undergoing elective cardiac surgery with use of cardiopulmonary bypass were treated intraoperatively with tranexamlc acid and then were randomized to one of three postoperative treatment groups: group A: 20 patients, infusion of saline for 12 h; group B: 20 pa tients, infusionbftranexamic acid, 1 mg • kg'1- hr1 for 12 hr group C: 20 patients, infusion of tranexamic acid, 2 mg • kg'1 • h'1 for 12 h. Bleeding was considered to be a primary outcome variable. Hematologic data, allogeneic transfusions, thromboiic complications, intubation time, and in tensive care unit and hospital stay duration also were evaluated.No dif ferences were found among groups regarding postoperative bleeding and outcomes; however, the group treated with 1 mgkg'^h'1 tranexamic acid required more units of packed red blood cells because of a significantly lower basal value of hematocrit, as shown by multivariale analysis. So, prolongation of treatment with tranexamic acid after cardiac surgery is not advantageous with respect to intraoperative administration alone in reducing bleeding and hence blood transfusion. Although the prevalence of postoperative complications was similar among groups, there is an in creased risk of procoagulant response because of antipbrinolytic treat ment. Therefore, the use of tranexamic acid during the postoperative peri od should be limited to patients with excessive bleeding as a result of primary ffbrinolysis.