VALUE OF LOCAL ADMINISTRATION OF TRANEXAMIC ACID IN CARDIAC SURGERY WITH CARDIOPULMONARY BYPASS

Peri-operative bleeding in surgeries with cardiopulmonary bypass results in the increase of post-operative complications and mortality. Fibrinolysis hyperactivation is the common cause of non-operative bleeding. Materials and methods. 60 patients who had cardiac surgery with cardiopulmonary bypass w...

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Main Authors: S. I. Sergey, A. G. Yavorovskiy, T. P. Zyulyaeva, O. V. Dymova
Format: Article
Language:Russian
Published: New Terra Publishing House 2018-01-01
Series:Вестник анестезиологии и реаниматологии
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Online Access:https://www.vair-journal.com/jour/article/view/155
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author S. I. Sergey
A. G. Yavorovskiy
T. P. Zyulyaeva
O. V. Dymova
author_facet S. I. Sergey
A. G. Yavorovskiy
T. P. Zyulyaeva
O. V. Dymova
author_sort S. I. Sergey
collection DOAJ
description Peri-operative bleeding in surgeries with cardiopulmonary bypass results in the increase of post-operative complications and mortality. Fibrinolysis hyperactivation is the common cause of non-operative bleeding. Materials and methods. 60 patients who had cardiac surgery with cardiopulmonary bypass were enrolled into the study. The antifibrinolytic agent (tranexamic acid) was administered to all patients: 32 patients (TA1) received an intravenous loading dose of tranexamic acid basing on 15 mg/kg during 20 min. with the consequent infusion of 1 mg/(kg × h-1) + 500 mg during cardiopulmonary bypass; 28 patients (TA2) received intravenous loading dose of tranexamic acid (15 mg/kg for 20 minutes) with the consequent infusion of 1 mg/(kg × h-1) + 500 mg during cardiopulmonary bypass + 1000 mg administered into the pericardial cavity and sternum before its closure. The peri-operative blood loss and volume of blood transfusion (erythrocyte suspension, fresh frozen plasma, platelet concentrate) were assessed. Results. Intra-operative blood loss made 815 (800–862) ml in TA1 group and 700 (650–735) ml in TA2 group. The volume of the post-operative blood loss in TA2 group was confidently lower compared to TA1 group: 170 (100–240) ml versus 275 (180–307) ml respectively. The frequency of erythrocyte suspension transfusion in the post-operative period did not differ significantly and the frequency of fresh frozen plasma transfusion was 2.5 lower in TA2 group compared to TA1 group. Conclusions. Blood-saving effect of the system administration of tranexamic acid is enhanced by local its administration into the pericardial cavity and sternum.
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spelling doaj-art-4dd37e1340b24e4bb420e13b6985e8d92025-08-20T02:59:46ZrusNew Terra Publishing HouseВестник анестезиологии и реаниматологии2078-56582541-86532018-01-01143101710.21292/2078-5658-2017-14-3-10-17155VALUE OF LOCAL ADMINISTRATION OF TRANEXAMIC ACID IN CARDIAC SURGERY WITH CARDIOPULMONARY BYPASSS. I. Sergey0A. G. Yavorovskiy1T. P. Zyulyaeva2O. V. Dymova3I. M. Sechenov First Moscow State Medical University, MoscowI. M. Sechenov First Moscow State Medical University, Moscow; B. V. Petrovsky Russian Research Surgery Center, MoscowB. V. Petrovsky Russian Research Surgery Center, MoscowB. V. Petrovsky Russian Research Surgery Center, MoscowPeri-operative bleeding in surgeries with cardiopulmonary bypass results in the increase of post-operative complications and mortality. Fibrinolysis hyperactivation is the common cause of non-operative bleeding. Materials and methods. 60 patients who had cardiac surgery with cardiopulmonary bypass were enrolled into the study. The antifibrinolytic agent (tranexamic acid) was administered to all patients: 32 patients (TA1) received an intravenous loading dose of tranexamic acid basing on 15 mg/kg during 20 min. with the consequent infusion of 1 mg/(kg × h-1) + 500 mg during cardiopulmonary bypass; 28 patients (TA2) received intravenous loading dose of tranexamic acid (15 mg/kg for 20 minutes) with the consequent infusion of 1 mg/(kg × h-1) + 500 mg during cardiopulmonary bypass + 1000 mg administered into the pericardial cavity and sternum before its closure. The peri-operative blood loss and volume of blood transfusion (erythrocyte suspension, fresh frozen plasma, platelet concentrate) were assessed. Results. Intra-operative blood loss made 815 (800–862) ml in TA1 group and 700 (650–735) ml in TA2 group. The volume of the post-operative blood loss in TA2 group was confidently lower compared to TA1 group: 170 (100–240) ml versus 275 (180–307) ml respectively. The frequency of erythrocyte suspension transfusion in the post-operative period did not differ significantly and the frequency of fresh frozen plasma transfusion was 2.5 lower in TA2 group compared to TA1 group. Conclusions. Blood-saving effect of the system administration of tranexamic acid is enhanced by local its administration into the pericardial cavity and sternum.https://www.vair-journal.com/jour/article/view/155tranexamic acidfibrinolysiscardiopulmonary bypassblood transfusionblood loss
spellingShingle S. I. Sergey
A. G. Yavorovskiy
T. P. Zyulyaeva
O. V. Dymova
VALUE OF LOCAL ADMINISTRATION OF TRANEXAMIC ACID IN CARDIAC SURGERY WITH CARDIOPULMONARY BYPASS
Вестник анестезиологии и реаниматологии
tranexamic acid
fibrinolysis
cardiopulmonary bypass
blood transfusion
blood loss
title VALUE OF LOCAL ADMINISTRATION OF TRANEXAMIC ACID IN CARDIAC SURGERY WITH CARDIOPULMONARY BYPASS
title_full VALUE OF LOCAL ADMINISTRATION OF TRANEXAMIC ACID IN CARDIAC SURGERY WITH CARDIOPULMONARY BYPASS
title_fullStr VALUE OF LOCAL ADMINISTRATION OF TRANEXAMIC ACID IN CARDIAC SURGERY WITH CARDIOPULMONARY BYPASS
title_full_unstemmed VALUE OF LOCAL ADMINISTRATION OF TRANEXAMIC ACID IN CARDIAC SURGERY WITH CARDIOPULMONARY BYPASS
title_short VALUE OF LOCAL ADMINISTRATION OF TRANEXAMIC ACID IN CARDIAC SURGERY WITH CARDIOPULMONARY BYPASS
title_sort value of local administration of tranexamic acid in cardiac surgery with cardiopulmonary bypass
topic tranexamic acid
fibrinolysis
cardiopulmonary bypass
blood transfusion
blood loss
url https://www.vair-journal.com/jour/article/view/155
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AT agyavorovskiy valueoflocaladministrationoftranexamicacidincardiacsurgerywithcardiopulmonarybypass
AT tpzyulyaeva valueoflocaladministrationoftranexamicacidincardiacsurgerywithcardiopulmonarybypass
AT ovdymova valueoflocaladministrationoftranexamicacidincardiacsurgerywithcardiopulmonarybypass