The use of fibrinolysis inhibitors in cardiac surgery with cardiopulmonary bypass (literature review)

In cardiac surgery with cardiopulmonary bypass (CPB) is a common complication. The incidence of this complication in cardiac surgery patients is estimated at about 10%. For this reason, the introduction of a patient blood management (PBM) in cardiac surgery is extremely relevant. Antifibrinolytic th...

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Main Authors: V. Yu. Medvedeva, K. N. Khrapov, A. A. Khryapa, K. Yu. Kankova
Format: Article
Language:Russian
Published: New Terra Publishing House 2024-08-01
Series:Вестник анестезиологии и реаниматологии
Subjects:
Online Access:https://www.vair-journal.com/jour/article/view/1038
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author V. Yu. Medvedeva
K. N. Khrapov
A. A. Khryapa
K. Yu. Kankova
author_facet V. Yu. Medvedeva
K. N. Khrapov
A. A. Khryapa
K. Yu. Kankova
author_sort V. Yu. Medvedeva
collection DOAJ
description In cardiac surgery with cardiopulmonary bypass (CPB) is a common complication. The incidence of this complication in cardiac surgery patients is estimated at about 10%. For this reason, the introduction of a patient blood management (PBM) in cardiac surgery is extremely relevant. Antifibrinolytic therapy is a key pharmacological tool of a multimodal PBM in cardiac surgery with CPB. The use of antifibrinolytics (tranexamic acid (TXA) and epsilon aminocaproic acid (EACA)) is standard practice in complex cardiac surgery with CPB. However, there is currently ongoing discussion regarding the search for the optimal dose of EACA and TXA to achieve an effective concentration in blood plasma in order to inhibit fibrinolysis with the minimization of adverse events. The use of aprotinin has a number of potential advantages, but its use in routine clinical practice is significantly limited. This review presents modern approaches to antifibrinolytic therapy, examines the mechanisms of action of the main drugs, highlights the side effects associated with the use of antifibrinolytic agents.
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series Вестник анестезиологии и реаниматологии
spelling doaj-art-ffecd8d511d7491c906bb49c7b4c968f2025-08-20T03:42:56ZrusNew Terra Publishing HouseВестник анестезиологии и реаниматологии2078-56582541-86532024-08-012149210310.24884/2078-5658-2024-21-4-92-103700The use of fibrinolysis inhibitors in cardiac surgery with cardiopulmonary bypass (literature review)V. Yu. Medvedeva0K. N. Khrapov1A. A. Khryapa2K. Yu. Kankova3Pavlov UniversityPavlov UniversityPavlov UniversityPavlov UniversityIn cardiac surgery with cardiopulmonary bypass (CPB) is a common complication. The incidence of this complication in cardiac surgery patients is estimated at about 10%. For this reason, the introduction of a patient blood management (PBM) in cardiac surgery is extremely relevant. Antifibrinolytic therapy is a key pharmacological tool of a multimodal PBM in cardiac surgery with CPB. The use of antifibrinolytics (tranexamic acid (TXA) and epsilon aminocaproic acid (EACA)) is standard practice in complex cardiac surgery with CPB. However, there is currently ongoing discussion regarding the search for the optimal dose of EACA and TXA to achieve an effective concentration in blood plasma in order to inhibit fibrinolysis with the minimization of adverse events. The use of aprotinin has a number of potential advantages, but its use in routine clinical practice is significantly limited. This review presents modern approaches to antifibrinolytic therapy, examines the mechanisms of action of the main drugs, highlights the side effects associated with the use of antifibrinolytic agents.https://www.vair-journal.com/jour/article/view/1038fibrinolysis inhibitorsbleedingaminocaproic acidtranexamic acidaprotinincardiac surgery with cardiopulmonary bypass (cpb)
spellingShingle V. Yu. Medvedeva
K. N. Khrapov
A. A. Khryapa
K. Yu. Kankova
The use of fibrinolysis inhibitors in cardiac surgery with cardiopulmonary bypass (literature review)
Вестник анестезиологии и реаниматологии
fibrinolysis inhibitors
bleeding
aminocaproic acid
tranexamic acid
aprotinin
cardiac surgery with cardiopulmonary bypass (cpb)
title The use of fibrinolysis inhibitors in cardiac surgery with cardiopulmonary bypass (literature review)
title_full The use of fibrinolysis inhibitors in cardiac surgery with cardiopulmonary bypass (literature review)
title_fullStr The use of fibrinolysis inhibitors in cardiac surgery with cardiopulmonary bypass (literature review)
title_full_unstemmed The use of fibrinolysis inhibitors in cardiac surgery with cardiopulmonary bypass (literature review)
title_short The use of fibrinolysis inhibitors in cardiac surgery with cardiopulmonary bypass (literature review)
title_sort use of fibrinolysis inhibitors in cardiac surgery with cardiopulmonary bypass literature review
topic fibrinolysis inhibitors
bleeding
aminocaproic acid
tranexamic acid
aprotinin
cardiac surgery with cardiopulmonary bypass (cpb)
url https://www.vair-journal.com/jour/article/view/1038
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