CAN TOPICAL TRANEXAMIC ACID APPLICATION ON PUMP CORONARY ARTERY BYPASS GRAFT SURGERY REDUCE POSTOPERATIVE BLOOD LOSS
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2018, Vol 7, Issue 5
Abstract
BACKGROUND Postoperative blood loss remains a major concern in cardiac surgeries. At least 30% of the times, the cause for blood loss is attributed to diffuse microvascular bleeding. [1] It results from a multifactorial coagulopathy in which the predominant factors are thrombocytopenia, acquired platelet dysfunction, loss of clotting factors, unneutralised heparin and increased fibrinolysis. Objective- Postoperative blood loss remains a major concern in cardiac surgeries, where microvascular bleeding is an important factor due to various reasons including the use of cardiopulmonary bypass pump [CPB]. Tranexamic acid [TA] is extensively being used in major surgeries to reduce perioperative blood loss. Topical application may reduce the incidence of thrombotic complications in coronary artery bypass surgeries [CABG] as compared to its parenteral supplementation as well as effective in reducing postoperative blood loss. MATERIALS AND METHODS This was a prospective, randomised, double-blinded study. Randomisation was done taking lots, where both the Surgeon and the Anaesthesiologist were blinded to drug being used. A total of 60 patients, wherein half the number of patients were allocated to receive the TA 2 gm diluted in 200 mL normal saline topically as compared to the other half receiving only normal saline. The postoperative bleeding was analysed at 2, 8 and 24 hours. RESULTS There was mild reduction in the amount of blood loss in the TA group during all the periods, 112 mL v/s 125 mL at 2 hours, 343 mL v/s 391 mL at 8 hours and 541 mL v/s 639 mL at 24 hours. CONCLUSION In our study, we observed lesser drainage in TA group consistently till 24 hours postoperatively, but without achieving statistical significance.
Authors and Affiliations
Anand Rampure Vittal Rao, Muralidhar Anakapalli
Keywords
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- EP ID EP285955
- DOI 10.14260/jemds/2018/130
- Views 89
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