Comparison of lokal or systemic administration of Tranexamic acid on blood loss in cardiac surgery

Tranexamic Acid decreases postoperative blood loss and blood transfusion requirements in patients undergoing cardiac surgery significantly. The aim of this prospective, randomized, double-blind study was to compare the effects between systemic or topically administration of Tranexamic Acid following cardiac surgery.60 patients aged over 18 years, undergoing primary non-emergent coronary bypass surgery were enrolled into the study.At the end of surgery following administration of protamine sulfate patients were randomly allocated into one of the two groups. In group 1 ( n=30) Tranexamic Acid 40 mg kg-1 was given as a single dose intravenously and the pericardial cavity was irrigated with 100 ml of saline; in group 2 (n=30) pericardial cavity was irrigated with 2 grams of tranexemic acid diluted in 100 ml of saline and 100 ml saline was infused intravenously.After the patient was transferred to the intensive care unit, at 3rd, 12th and 24th postoperative hours, hematologic studies including activated clotting time, hemoglobin, hematocrit, prothrombin time, partial thromboplastin time were measured, and the amount of mediastinal tube drainage and, blood and blood products used were recorded. The patients were followed to detect significantly adverse effects and reoperation for bleeding.All recorded variables were similar in both groups. There was no statistically significant difference between the groups regarding, the amount of postoperative blood loss, amount of red blood cell and other blood product transfused and the hematologic studies performed. No significant complications were observed and no patient was re-explored for bleeding in both groups.Conclusion: systemic or topical administered Tranexemic Acid has similar effects following primary Coronary Artery Bypass Graft (CABG) regarding postoperative bleeding and the use of blood and blood products with no significantly adverse effects.Key words: Coronary Artery Bypass Graft (CABG), Tranexamic Acid, topical, re-operation, bleeding