Key result
Tranexamic acid cuts 24-hour mediastinal drainage ~30% and reduces transfusions in repeat cardiac surgery.
Why the study?
The administration of tranexamic acid prior to cardiopulmonary bypass has been associated with reduced bleeding during and after cardiac surgery, but its effects in repeat cardiac surgery patients required evaluation.
Does tranexamic acid reduce mediastinal drainage and transfusions in adult patients undergoing repeat open heart surgery?
Comparison
Tranexamic acid 20 mg/kg IV initial dose plus infusion vs equal volume saline placebo
Design
Prospective, randomized, controlled, double-blind clinical trial
Follow-up
72 hours
Authors
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Supports prophylactic tranexamic acid in repeat cardiac surgery to reduce bleeding and transfusions; extends prior evidence to reoperative patients.
RCT (n=30)
Double-blind
randomized
Does tranexamic acid reduce mediastinal drainage and transfusions in adult patients undergoing repeat open heart surgery?
Absolute Event Rate: 649% vs 923%
p-value: p=<0.01
Prophylactic use of tranexamic acid prior to cardiopulmonary bypass in repeat cardiac surgery significantly reduces postoperative mediastinal drainage and the need for allogeneic transfusions.
Shore‐Lesserson et al. (1996) conducted an RCT in Repeat cardiac surgery (n=30). Tranexamic acid vs. Saline placebo was evaluated on Cumulative postoperative mediastinal tube drainage at 24 h (ml) (p=<0.01). Tranexamic acid administered prior to cardiopulmonary bypass significantly reduced 24-hour mediastinal tube drainage (649 vs 923 ml; P<0.01) and allogeneic transfusions in repeat cardiac surgery.
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