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Efficacy of epsilon-aminocaproic acid in children undergoing cardiac surgery

G D Williams1, S L Bratton, E C Riley

  • 1Department of Anesthesiology, University of Washington School of Medicine, Seattle, USA.

Journal of Cardiothoracic and Vascular Anesthesia
|July 7, 1999
PubMed

Insights

Epsilon-aminocaproic acid (EACA) reduced intraoperative blood loss in pediatric cardiac surgery patients but did not significantly decrease blood product transfusions. Further studies are needed to explore optimal dosing for efficacy.

Area of Science:

  • Cardiology
  • Anesthesiology
  • Pediatric Surgery

Background:

  • Bleeding is a significant complication in pediatric cardiac surgery.
  • Prophylactic antifibrinolytic agents like epsilon-aminocaproic acid (EACA) are used to reduce blood loss.
  • Optimal EACA dosing in pediatric cardiac surgery remains under investigation.

Purpose of the Study:

  • To compare coagulation test results, blood loss, and blood product transfusions between children receiving prophylactic EACA and a control group.
  • To evaluate the efficacy of EACA in reducing bleeding complications during pediatric cardiac surgery.

Main Methods:

  • A nested case-control study was conducted at a pediatric medical center.
  • 70 patients receiving prophylactic EACA were matched with 70 control patients.
  • EACA was administered intravenously (load and infusion) to patients at increased risk for bleeding.

Main Results:

  • The EACA group showed significantly less intraoperative blood loss (p = 0.02).
  • No significant differences were observed in postoperative chest tube output between groups.
  • Fewer patients in the EACA group required reexploration for bleeding (p < 0.05), and coagulation parameters were better preserved.

Conclusions:

  • EACA effectively reduced intraoperative blood loss in pediatric cardiac surgery.
  • EACA did not significantly decrease blood product transfusions, possibly due to underdosing.
  • Further research is warranted to determine optimal EACA dosing strategies for improved efficacy.
Abstract

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