Application Of Two Different Doses Of Tranexamic Acid In Cardiac Surgery With Cardiopulmonary Bypass

Background and Aims:Tranexamic acid(TA)is widely used for reducing the risk of bleeding in patients underdoing cardiac surgery.But the dose of TA that effectively reduces perioperative bleeding remains unclear.We evaluated the efficacy of two different doses of TA by using therombelastography(TEG)among patients undergoing cardiac surgery with cardiopulmonary bypass(CPB).Methods:Patients who underwent elective cardiac surgery with cardiopulmonary bypass were enrolled.All patients underwent first cardiac surgery,ASA grade II to III,and NYHA cardiac function grade II to III.Patients were divided into two groups using a random number table:low-dose TA group(TA,n=76)and control group(C,n=35),and we randomly assigned patients of the low dose TA group to receive different doses of TA:15 mg/kg loading dose followed by infusion of 5mg/kg/h until the end of sugery(TA1 group)or 6 mg/kg loading dose followed by infusion of 3 mg/kg/h until the end of surgery(TA2 group).Record preoperative information,extracorporeal circulation time and aortic occlusion time during surgery,intraoperative blood transfusion and protamine use,and record the amount of postoperative thoracic drainage and postoperative data.TEG was used to evaluate the hemostatic system of all patients and participated in the perioperative transfusion management.Results:Transfusion of blood products,blood loss,chest tube output were significantly reduced in the TA group compared with the control group(P<0.05).The operation time,length of intensive unit(ICU)stay were significantly diminished in the TA group compared with the control group(P<0.05).There was no postoperative seizures occurred in three group.Conclusions:Tranexamic acid is associated with a lower risk of bleeding than the control group.And both of the two doses of tranexmaic acid are more effective to reduce blood loss,transfusion needs than the control group.