Application of tranexamic acid combined with acute normovolemic hemodilution in off-pump coronary artery bypass grafting

Abstract

Abstract:

AIM: To investigate the effect of tranexamic acid plus acute normovolemic hemodilution (ANH) in off-pump coronary artery bypass grafting (OPCABG) patients. METHODS: Sixty ASA physical status II-III patients，aged 45-70 years，with body mass index of 20-23 kg/m², scheduled for elective undergoing OPCABG were randomly divided into 3 groups (n=20): control group (group C), tranexamic acid group ( group T), tranexamic acid combined with ANH group (group T+A). Group C received no treatment. After induction of anesthesia, tranexamic acid 20 mg/kg was intravenously infused in 30 min followed by continuous infusion at 10 mg·kg^-1·h^-1 until the end of operation in group T. Tranexamic acid was intravenously infused combined with ANH in group T+A. Coagulation parameters such as Hb, Hct, Plt, PT, INR and D-dimer were recorded before operation, after operation and 24 h after operation, respectively. The volume of chest tube drainage was collected and recorded at 6 h and 24 h after operation. The transfusion of allogeneic red blood cells and fresh frozen plasma within 24 h were also recorded. RESULTS:Compared with group C, the D-dimmer level decreased significantly in group T and group T+A right after the operation and 24 h after the operation, and the volume of chest tube drainage as well as the requirement for transfusion of allogeneic red blood cells were reduced (P<0.05). No significant changes were found in Hb, Hct, Plt and INR at each time point between all groups (P>0.05). Compared with group T, the volume of chest tube drainage and the requirement for transfusion of allogeneic red blood cells were reduced (P<0.05) in group T+A. No development of death and complications during days of hospitalization was observed in the three groups. CONCLUSION: Tranexamic acid combined with ANH exhibit a synergistic effect of blood-saving and has no significant effect on coagulation function of patients undergoing OPCABG surgery.

Key words: tranexamic acid, acute normovolemic hemodilution, off-pump coronary artery bypass grafting, coagulation

CLC Number:

R614

LI Yan, ZHANG Song, ZHOU Ying, QI Yong, GUO Jianrong. Application of tranexamic acid combined with acute normovolemic hemodilution in off-pump coronary artery bypass grafting[J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2017, 22(5): 584-588.

References

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