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Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado

2010, Number 1

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Rev Esp Med Quir 2010; 15 (1)

Epsilon aminocaproic acid efficacy in the reduction of postoperative bleeding in cardiac surgery

Vilchis LR, Pantoja A, García CG, Girón AE, Aceves CJL

Language: Spanish
References: 20
Page: 27-31
PDF size: 202.98 Kb.


ABSTRACT

Objective: To report the effectiveness of low-dose EACA in patients undergoing cardiac surgery with cardiopulmonary bypass to reduce postoperative bleeding and blood product consumption.
Patients and method: We included patients underwent to cardiac surgery. All patients were randomized to EACA group (10 mg/kg/hour) or placebo group. We registered age, sex, weight, size, surgery procedure, extracorporeal bypass and aorta clamping time, postoperative bleeding at 4 h, 24 h and until withdrawal pleura-mediastinal tubes and blood products consumption. We used t student and chi square to determine differences between the groups according to continuous and nominal variables, respectively. We considered statistical significance with p ‹ 0.05.
Results: We included 86 patients (cases n = 43 and controls n = 43). In both groups we do not observed significant differences in preoperative characteristics of patients, surgical procedure, extracorporeal bypass and aorta clamping time. The postoperative variables showed significant differences between groups: bleeding and bank blood consumption was reduced in EACA group (total bleed EACA 368 ± 180 mL vs placebo 511 ‹ 109 mL p ‹ 0.001). In placebo group the hemoglobin, hematocrit and platelet levels were more reduced at final surgery (Hb EACA 12 ± 1.3 vs placebo 9 ± 1 p ‹ 0.001; Hto. AEAC 31 ± 3.6 vs placebo 27 ± 3 p ‹ 0.001; platelets x 103 EACA 165 ± 48 vs placebo 130 ± 12 p ‹ 0.001), coagulation test was prolonged (TP EACA 25 ± 5 vs placebo 35 ± 4 p ‹ 0.03; TPT EACA 44 ± 5 vs placebo 50 ± 1 p ‹ 0.01) with high consumption of bank blood products (GP EACA 2.3 ± 0.5 vs placebo 5.2 ± 1.1 p ‹ 0.001 y CP EACA 2.5 ± 0.7 vs placebo 6.1 ± 1.2 p ‹ 0.001)
Conclusions: The epsilon aminocaproic acid at low doses is effective in postoperative bleeding reduction in patients underwent to cardiac surgery with extracorporeal circulatory bypass, and low blood bank products consumption.


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