Tranexamic Acid Reduces Postoperative Blood Loss In Patients Undergoing Cardiac Surgery Under Cardiopulmonary Bypass:A Retrospective Analysis

Objective:Since recognition of the detrimental effect of aprotinin, tranexamic acid has been used more often. The purpose of our study is to retrospectively evaluate the effectiveness and safety of tranexamic acid in patients undergoing cardiac surgery under cardiopulmonary bypassMethods:Data were collected from patients undergoing cardiac surgery under cardiopulmonary bypass between October in2009and December in2013in the Second Affiliated Hospital of Zhejiang University, including congenital heart disease surgery, coronary artery bypass grafting and valve replacement. Tranexamic acid group is defined as patients undergoing cardiopulmonary bypass with intraoperative usage of tranexamic acid; while control group is defined as patients undergoing cardiopulmonary bypass without using tranexamic acid. Result:1823cases were involved in total.798patients belongs to tranexamic acid group, while1025patients belongs to control group, demographic data showed no differences. During the first24hours after surgery, the blood loss of tranexamic acid group and control group were (523.6±232.4)ml,(813.2±245.8)ml(P<0.05), respectively. Plasma transfusion from the beginning of surgery to the first24hours after surgery for tranexamic acid group and control group were(278.5±97.3)ml,(576.2±167.3) ml(P<0.05), respectively; red blood cells transfusion were(4.9±1.5)U and (8.6±2.8)U(P<0.05), while respectively.platlet transfusion were (2.3±0.9)U,(3.9±1.2)U(P<0.05), respectively.The incidence of a second thoracotomy were lower in tranexamic acid group(P<0.05). For in-hospital mortality rate, complications (postoperative renal function, lung infection and brain complication) and a secont endotracheal intubation rate, there was no significant difference between two groups.Conclusion:Application of tranexamic acid in cardiac surgery under cardiopulmonary bypass significantly reduces the first24hours’postoperative blood loss, blood transfusion as well as a second thoracotomy rate, without influencing perioperative mortality or incidence of major complications.