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Epsilon-aminocaproic acid influence in postoperative [corrected] bleeding and hemotransfusion [corrected] in mitral
Ricardo Ádala Benfatti1, Amanda Ferreira Carli, Guilherme Viotto Rodrigues da Silva
1UFMS, Campo Grande, MS, Brasil. ricardobenfatti@gmail.com
Insights
Epsilon aminocaproic acid significantly reduced bleeding and red-cell transfusion needs in patients undergoing mitral valve surgery. This antifibrinolytic agent proved effective in the immediate postoperative period, improving patient outcomes.
Area of Science:
- Cardiovascular Surgery
- Pharmacology
Background:
- Epsilon aminocaproic acid (EACA) is an established antifibrinolytic agent.
- It is utilized in cardiovascular surgery to mitigate blood loss post-cardiopulmonary bypass (CPB).
Purpose of the Study:
- To evaluate the impact of EACA on postoperative bleeding.
- To assess the effect of EACA on red-cell transfusion requirements within 24 hours after mitral valve surgery.
Main Methods:
- A prospective, randomized study involving 42 patients undergoing mitral valve surgery.
- Patients were divided into two groups: a control group (saline infusion) and an EACA group (25g total dose).
- EACA was administered at specific intervals: anesthesia induction, CPB perfusate, and post-surgery.
Main Results:
- The EACA group exhibited significantly lower average bleeding volume (308.81 ± 210.1 ml) compared to the control group (633.57 ± 305.7 ml) (P = 0.0003).
- Red-cell transfusion requirements were substantially reduced in the EACA group (214.29 ± 330.58 ml) versus the control group (942.86 ± 345.79 ml) (P < 0.0001).
Conclusions:
- Epsilon aminocaproic acid effectively decreases bleeding volume after mitral valve surgery.
- EACA administration significantly lowers the need for red-cell transfusions in the early postoperative phase.
Introduction:
The epsilon aminocaproic acid is an antifibrinolytic used in cardiovascular surgery to inhibit the fibrinolysis and to reduce the bleeding after CPB. [corrected]
Objective:
To analyze the influence of the using of epsilon aminocaproic acid in the bleeding and in red-cell transfusion requirement in the first twenty-four hours postoperative of mitral valve surgery.
Methods:
Prospective studying, forty-two patients, randomized and divided in two equal groups: group #1 control and group #2--epsilon aminocaproic acid. In Group II were infused five grams of EACA in the induction of anesthesia, after full heparinization, CPB perfusate after reversal of heparin and one hour after the surgery, totaling 25 grams. In group I, saline solution was infused only in those moments.
Results:
Group #1 showed average bleeding volume of 633.57 ± 305,7 ml, and Group #2, an average of 308.81 ± 210.1 ml, with significant statistic difference (P = 0.0003). Average volume of red-cell transfusion requirement in Groups 1 and 2 was, respectively, 942.86 ± 345.79 ml and 214.29 ± 330.58 ml, with significant difference (P < 0.0001).
Conclusion:
The epsilon aminocaproic acid was able to reduce the bleeding volume and the red-cell transfusion requirement in the immediate postoperative of patients submitted to mitral valve surgery.
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