Additional effects of topical tranexamic acid in on-pump cardiac surgery

© The Author(s) 2016. Objective Postoperative bleeding after cardiac surgery is commonly associated with hyperfibrinolysis. This study was designed to evaluate the efficacy of topical tranexamic acid in addition to intravenous tranexamic acid in reducing bleeding in cardiac surgery cases. Methods Fr...

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Main Authors: Taksaudom N., Siwachat S., Tantraworasin A.
Format: Journal
Published: 2017
Online Access:https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85009743334&origin=inward
http://cmuir.cmu.ac.th/jspui/handle/6653943832/40963
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Institution: Chiang Mai University
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spelling th-cmuir.6653943832-409632017-09-28T04:14:49Z Additional effects of topical tranexamic acid in on-pump cardiac surgery Taksaudom N. Siwachat S. Tantraworasin A. © The Author(s) 2016. Objective Postoperative bleeding after cardiac surgery is commonly associated with hyperfibrinolysis. This study was designed to evaluate the efficacy of topical tranexamic acid in addition to intravenous tranexamic acid in reducing bleeding in cardiac surgery cases. Methods From July 1, 2014 to September 30, 2015, 82 patients who underwent elective on-pump cardiac surgery were randomized into a tranexamic acid group and a placebo group. In the tranexamic acid group, 1 g of tranexamic acid dissolved in 100 mL of normal saline solution was poured into the pericardium during sternal closure; the placebo group had 100 mL of saline only. Two patients were excluded from the study due to obvious surgical bleeding. The primary endpoint was total blood loss 24 h after surgery. Repeated measures with mixed models was used to analyze bleeding over time. Results There was no significant difference in demographic and intraoperative data except for a significantly lower platelet count preoperatively in the tranexamic acid group (p = 0.030). There was no significant difference in postoperative drainage volumes at 8, 16, and 24 h, postoperative bleeding over time (coefficient = 0.713, p = 0.709), or blood product transfusion between the groups. There were no serious complications. Conclusions Topical tranexamic acid is safe but it adds no additional efficacy to the intravenous application in reducing postoperative blood loss. Intravenous tranexamic acid administration alone is sufficient antifibrinolytic treatment to enhance the hemostatic effects during on-pump cardiac surgery. 2017-09-28T04:14:49Z 2017-09-28T04:14:49Z 2017-01-01 Journal 02184923 2-s2.0-85009743334 10.1177/0218492316683759 https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85009743334&origin=inward http://cmuir.cmu.ac.th/jspui/handle/6653943832/40963
institution Chiang Mai University
building Chiang Mai University Library
country Thailand
collection CMU Intellectual Repository
description © The Author(s) 2016. Objective Postoperative bleeding after cardiac surgery is commonly associated with hyperfibrinolysis. This study was designed to evaluate the efficacy of topical tranexamic acid in addition to intravenous tranexamic acid in reducing bleeding in cardiac surgery cases. Methods From July 1, 2014 to September 30, 2015, 82 patients who underwent elective on-pump cardiac surgery were randomized into a tranexamic acid group and a placebo group. In the tranexamic acid group, 1 g of tranexamic acid dissolved in 100 mL of normal saline solution was poured into the pericardium during sternal closure; the placebo group had 100 mL of saline only. Two patients were excluded from the study due to obvious surgical bleeding. The primary endpoint was total blood loss 24 h after surgery. Repeated measures with mixed models was used to analyze bleeding over time. Results There was no significant difference in demographic and intraoperative data except for a significantly lower platelet count preoperatively in the tranexamic acid group (p = 0.030). There was no significant difference in postoperative drainage volumes at 8, 16, and 24 h, postoperative bleeding over time (coefficient = 0.713, p = 0.709), or blood product transfusion between the groups. There were no serious complications. Conclusions Topical tranexamic acid is safe but it adds no additional efficacy to the intravenous application in reducing postoperative blood loss. Intravenous tranexamic acid administration alone is sufficient antifibrinolytic treatment to enhance the hemostatic effects during on-pump cardiac surgery.
format Journal
author Taksaudom N.
Siwachat S.
Tantraworasin A.
spellingShingle Taksaudom N.
Siwachat S.
Tantraworasin A.
Additional effects of topical tranexamic acid in on-pump cardiac surgery
author_facet Taksaudom N.
Siwachat S.
Tantraworasin A.
author_sort Taksaudom N.
title Additional effects of topical tranexamic acid in on-pump cardiac surgery
title_short Additional effects of topical tranexamic acid in on-pump cardiac surgery
title_full Additional effects of topical tranexamic acid in on-pump cardiac surgery
title_fullStr Additional effects of topical tranexamic acid in on-pump cardiac surgery
title_full_unstemmed Additional effects of topical tranexamic acid in on-pump cardiac surgery
title_sort additional effects of topical tranexamic acid in on-pump cardiac surgery
publishDate 2017
url https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85009743334&origin=inward
http://cmuir.cmu.ac.th/jspui/handle/6653943832/40963
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