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Efficacy of tranexamic acid as compared to aprotinin in open heart surgery in children.
Ann Card Anaesth ; 2015 Jan-Mar ; 18(1): 23-26
Artigo em Inglês | IMSEAR | ID: sea-156496
ABSTRACT

Background:

Coagulopathy is a major issue in children undergoing high‑risk pediatric cardiac surgery. Use of anti‑fibrinolytics is well documented in adults, but recently there are questions raised about safety and effectiveness of their use on routine use. Tranexamic acid is a potent anti‑fibrinolytic, but its role is not fully understood in children. This study aims to study the benefits tranexamic acid in controlling postoperative bleeding in pediatric cardiac surgical patients. Methods and

Results:

Fifty consecutive children who underwent cardiac surgery were randomized prospectively to receive either aprotinin (Group A; n = 24) or tranexamic acid (Group B; n = 26) from September 2009 to February 2010 were studied. Primary end points were early mortality, postoperative drainage, reoperation for bleeding and complications. Mean age and body weight was smaller in Group A (Age 48.55 vs. 64.73 months; weight 10.75 vs. 14.80 kg) respectively. Group A had more cyanotic heart disease than Group B (87.5% vs. 76.92%). Mean cardiopulmonary bypass time (144.33 vs. 84.34 min) and aortic cross‑clamp time (78.5 vs. 41.46 min) were significantly higher in group A. While the blood and products usage was significantly higher in Group A, there was no difference in indexed postoperative drainage in first 4, 8 and 12 h and postoperative coagulation parameters. Mean C‑reactive protein was less in Group A than B and renal dysfunction was seen more in Group A (25% vs. 7.6%). Mortality in Group A was 16.66% and 7.6% in Group B.

Conclusion:

Anti‑fibrinolytics have a definitive role in high‑risk children who undergo open‑heart surgery. Tranexamic acid is as equally effective as aprotinin with no additional increase in morbidity or mortality. Ultramini Abstract Coagulopathy has been a major issue in pediatric cardiac surgery, and anti‑fibrinolytics have been used fairly regularly in various settings. This study aims to evaluate the efficacy of tranexamic acid as compared against that of aprotinin in a randomized model. Tranexamic acid proves to be equally effective with less toxicity with no added mortality.
Assuntos

Texto completo: DisponíveL Índice: IMSEAR (Sudeste Asiático) Assunto principal: Ácido Tranexâmico / Humanos / Recém-Nascido / Criança / Pré-Escolar / Aprotinina / Mortalidade / Procedimentos Cirúrgicos Cardíacos / Hemorragia / Lactente Tipo de estudo: Ensaio Clínico Controlado / Estudo prognóstico Idioma: Inglês Revista: Ann Card Anaesth Ano de publicação: 2015 Tipo de documento: Artigo

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Texto completo: DisponíveL Índice: IMSEAR (Sudeste Asiático) Assunto principal: Ácido Tranexâmico / Humanos / Recém-Nascido / Criança / Pré-Escolar / Aprotinina / Mortalidade / Procedimentos Cirúrgicos Cardíacos / Hemorragia / Lactente Tipo de estudo: Ensaio Clínico Controlado / Estudo prognóstico Idioma: Inglês Revista: Ann Card Anaesth Ano de publicação: 2015 Tipo de documento: Artigo