ABSTRACT
Cardiovascular operations are associated with an inherent bleeding tendency that sometime leads to severe bleeding and transfusion requirement. Pharmacologic intervention to minimize post-bypass bleeding and blood product transfusions has received increasing attention for both medical and economic perspectives. In this double-blind, randomized, placebo-controlled clinical trial, three groups of patients, each comprising 50 patients undergoing on-pump coronary artery bypass grafting surgery [CABG] were blindly randomized to receive either low aprotinin, tranexamic acid, or placebo; the results were subsequently evaluated and compared between the groups. The following variables were similar in the groups, and there were no statistically significant differences in these variables: age [p value=0.308], sex [p valuco.973], hyperlipidemia [p value=0.720], hypertension [p value=0.786], smoking [p value=0.72], and diabetes [p value=0.960]. The amounts of drainage from chest tubes were less in the aprotinin and tranexamic acid groups compared to the placebo group, and this was statistically significant [p value<0.001]. There was no statistically significant difference in need for reoperation for bleeding between the three groups [p value=0.998]. Complications following surgery in the three groups were statistically the same and not significantly different [Table below]. All the complications had a good course, and all the patients were discharged from hospital uneventftilly. There was no mortality in any group. Low-dose aprotinin and tranexamic acid can significantly reduce blood loss and transfttsion requirement in CABG without importantly increasing mortality and morbidity
ABSTRACT
The purpose of this study was to investigate outcomes of surgical repair of esophageal atresia [EA] or tracheoesophageal fistula [TEF] in newborns, with respect to incidence of death and other complications in early or late operations. Charts of all 80 infants with EA/TEF, operated in Alzahra hospital [A tertiary hospital of Isfahan University of Medical Sciences] from 2002 to 2004 were reviewed. Patients were designed in two groups as, primary and delayed repair groups. Patients demographics, frequency of associated anomalies, and details of management and outcomes were studied. There were 48 male and 32 female patients with a frequency of 28[35%] preterm infant and mean birth weight of 2473 +/- 595 g. Overall survival rate was 71.2%. Mortality rate in delayed repair group was significantly higher than the other one [22.5% vs. 6.3%] but with matching, according to full term/preterm proportion, the significant differences were failed. Female sex and being preterm were the most powerful predictors of death [nearly odds ratio=7 for both]. in this study mortality and complications rates are higher in delayed repair than early one, although our data proposed that in absence of sever life threatening anomalies the most important factor for death is gestational age and female sex, and primary repair is opposed to it. Although mortality rate and complications are equal in two strategies, with matching cases for being preterm, but primary repair stays the better choice due to economic considerations