Authors

SOHRAB NEGARGAR*, BAHMAN NAGHIPOUR**, SHAHRIAR ANVARI***, ELGAR ENAMZADEH****, MARYAM SHIRIZADEH*****

Departments

* Professor of Anesthesiology and critical care, Cardiovascular research Centre of Tabriz University of Medical Sciences, Tabriz, Iran - **Assistant professor of Anesthesiology, Cardiovascular research Centre of Tabriz University of Medical Sciences, Tabriz, Iran - ***Assistant professor of Cardiovascular surgery, Cardiovascular research Centre of Tabriz University of Medical Sciences, Tabriz, Iran - ****Cardiologist, Cardiovascular research Centre of Tabriz University of Medical Sciences, Tabriz, Iran - *****M.D, Cardiovascular research Centre of Tabriz University of Medical Sciences, Tabriz, Iran

Abstract

´╗┐Introduction and objective: Bleeding caused by coagulopathy after Cardiopulmonary Bypass (CPB) leads to morbidity and mortality. Research results suggest thatTranexamic Acid (TA) plays a major role in reducing bleeding after heart surgery. The objective of this study was to compare the effect of preoperative TA and post-CPB TA on the decrease in bleeding after heart surgery.

Materials and methods: A total of 60 patients, who were candidates for Coronary Artery Bypass Graft (CABG), were randomly categorized into two groups after their written consent was obtained. First, before the surgery, TA was added to the serum of group I and normal saline was added to the serum of group II. After detachment from CPB, normal saline was injected to group I and TA was injected to group II. Postoperative bleeding was measured based on the volume of blood flowing into the chest bottle of patients and the number of blood units transfused to patients after surgery was recorded.

Results: Investigation results revealed that although bleeding during surgery in the pre-pump group was higher than the postpump group, the difference was not significant. The average volume of bleeding in the pre-pump group was higher than the postpump group, but the difference was not statistically significant either. Moreover, pre-pump TA did not lead to a reduction in the need for transfusion during surgery. The level of bleeding in the first 2 hours after hospitalization in ICU was significant lower in the prepump group. However, no significant difference was observed between the duration stay of the groups in ICU.

Conclusion: Pre-pump administration of TA did not result in a significant decrease in bleeding during surgery, need for transfusion, duration of stay in ICU, and duration of hospitalization as compared to post-pump TA administration.

Keywords

Tranexamic Acid, Bleeding, Cardiopulmonary bypass, Coronary Artery Bypass Graft Surgery.