Tranexamic Acid, a Low-cost and Practical Hemostatic Agent Against Diffuse Microvascular Bleeding Due to Coagulopathy in Heart Surgery

Özet

Objectives: Bleeding after open heart surgery is an important cause of morbidity and mortality. It may not always be related to surgical bleeding. Bleeding due to coagulopathy, called diffuse microvascular bleeding, is more commonly seen in the post-operative period. The objective of this study is to assess the effect of administering transamine, which we consider a low-cost and effective hemostatic agent, during open heart surgery on postoperative bleeding amount, blood product use, length of stay in intensive care, and duration of hospitalization. Materials and Methods: A total of 24 patients were enrolled in the study at the Hisar Intercontinental Hospital between March 2017-December 2017. 12 patients were administered tranexamic acid 10% 500 mg I.V. before starting sternal incision for open heart surgery. 10% 500 mg I.V. tranexamic acid dose was repeated during separation from the heart-lung machine at the end of the operation. The other 12 patients were followed-up as a control group. Patients were followed-up for drainage in the post-operative period. The patients were monitored for re-operation due to bleeding and significant side effects. Bleeding amounts and re-operation rates were compared. Results: When the results from the two groups were evaluated, revision rates, amounts of used blood and blood products, total drainage amount were less, and stay in intensive care and discharge time were shorter in the group given tranexamic acid. Conclusion: We think that tranexamic acid, which is used as a low-cost and effective pharmacological agent in heart surgery, will significantly reduce post-operative bleeding and the need for blood transfusion in patients undergoing heart surgery.