[Bleeding after extracorporeal circulation and epsilon-aminocaproic acid]

Area of Science:

• Cardiology
• Pharmacology
• Surgical Research

Background:

• Postoperative bleeding is a significant complication after aorto-coronary bypass grafting.
• Antifibrinolytic agents are sometimes used to mitigate bleeding risks.
• Epsilon aminocaproic acid is one such agent with potential hemostatic properties.

Purpose of the Study:

• To evaluate the efficacy of epsilon aminocaproic acid in reducing postoperative bleeding and transfusion requirements.
• To assess the impact of epsilon aminocaproic acid on fibrinolytic activity post-cardiac surgery.

Main Methods:

• A double-blind, placebo-controlled study was conducted with 57 patients undergoing aorto-coronary bypass grafting.
• Epsilon aminocaproic acid or placebo was administered post-extracorporeal circulation.
• Efficacy was measured by blood loss, transfusion needs, and fibrinolytic activity (Von Kaulla test).

Main Results:

• No statistically significant difference (p<0.05) in postoperative bleeding was observed between the epsilon aminocaproic acid and placebo groups.
• Blood transfusion requirements did not differ significantly between the treatment and placebo groups.
• Fibrinolytic activity, assessed one hour after protamine injection, showed no significant difference.

Conclusions:

• Epsilon aminocaproic acid demonstrated no significant benefit in reducing postoperative bleeding or transfusion needs after aorto-coronary bypass grafting.
• The routine use of epsilon aminocaproic acid following this type of cardiac surgery is not supported by the study findings.
• Further research may explore specific patient subgroups or alternative antifibrinolytic strategies.