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[Use of tranexamic acid for bleeding control in myocardial revascularization]
W J Couto1, F Gregori Júnior, C O Cordeiro
1Faculdade de Medicina, Universidade Estadual de Londrina e Hospital Evangélico.
Purpose:
To compare two groups of 80 patients undergoing to myocardial revascularization with the use of antifibrinolytic drug tranexamic acid and its efficacy in reduce bleeding and blood transfusion.
Methods:
Prospective analysis of two groups of 80 patients. Group A-no antifibrinolytic therapy (dec 91-may 92) and group B-fibrinolytic therapy-tranexamic acid-10g EV (jun-dec/92). Quantification of mediastinal drainage over 12h as well as the blood or derivatives received at the same time.
Results:
Hospital mortality: group A-3.8%, group B-2.5%. Drainage (12h): group A-602 +/- 547 ml and group B-260 +/- 260 ml (p < 0.001). Blood transfusion (12h): group A-1,782 +/- 1,163 ml and group B-1,105 +/- 839 ml (p < 0.001).
Complications:
group A-two cases of intraoperative myocardial infarction, one episode of jaundice; group B-one case of intraoperative MI, one reoperation for bleeding control, one episode of jaundice, one of renal insufficiency, two mediastinitis and one seizure. The mean hospitalization time was ten days in both groups.
Conclusion:
Tranexamic acid was an effective drug in bleeding control and in reducing blood transfusion in the postoperative of patients submitted to myocardial revascularization.