RESUMEN
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