ϵ-Aminocaproic acid is as efficient as dose aprotinin on per and post operative blood loss in cardiac surgery

AbstractIntroduction:Antiplatelet agents such as aspirin and clopidogrel are increasingly encountered in clinical practice. Otorhinolaryngological surgeons are involved in the peri-operative decision of whether to continue treatment and risk haemorrhage or to discontinue treatment and risk thrombosis.Methods:Literature relating to the risk of spontaneous or operative haemorrhage was reviewed. The morbidity and mortality associated with cessation of agents was evaluated. Published guidelines were also evaluated. A protocol for the management of antiplatelet agents in the peri-operative period, with particular reference to ENT operations, is presented.Conclusion:Significant morbidity and mortality is associated with the premature cessation of antiplatelet agents. Data from cardiac surgery suggest that operative blood loss only marginally increases in patients on aspirin and clopidogrel. However, the management of antiplatelet agents in the peri-operative period should be made after multidisciplinary consultation.

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Peri-operative blood-loss after total hip arthroplasty can be significantly reduced with topical application of epsilon-aminocaproic acid

International Orthopaedics ◽

10.1007/s00264-015-3103-1 ◽

2016 ◽

Vol 40 (10) ◽

pp. 2019-2023 ◽

Cited By ~ 11

Author(s):

Mark G. Sucher ◽

Mauro Giordani ◽

Andrew Figoni ◽

Alexander J. Nedopil

Keyword(s):

Total Hip Arthroplasty ◽

Blood Loss ◽

Topical Application ◽

Hip Arthroplasty ◽

Aminocaproic Acid ◽

Operative Blood Loss ◽

Total Hip ◽

Epsilon Aminocaproic Acid

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Local administration of epsilon-aminocaproic acid reduces post-operative blood loss from surgery for closed, Sanders III–IV calcaneal fractures

International Orthopaedics ◽

10.1007/s00264-021-05268-y ◽

2022 ◽

Author(s):

Lang Zhong ◽

Yangbo Xu ◽

Yongcai Wang ◽

Yu Liu ◽

Qiu Huang

Keyword(s):

Blood Loss ◽

Aminocaproic Acid ◽

Wound Complications ◽

Local Administration ◽

Control Group ◽

Calcaneal Fractures ◽

Operative Blood Loss ◽

Significant Difference ◽

Operative Drainage ◽

And Control

Abstract Purpose To investigate whether local administration of epsilon-aminocaproic acid (EACA) is effective and safe in reducing the post-operative blood loss in surgery for Sanders III–IV calcaneal fractures. Methods Patients with Sanders III–IV calcaneal fractures who were hospitalized in our hospital from January 2016 to February 2021 and underwent open reduction internal fixation (ORIF) via lateral approach with an L-shaped incision were included in the current study. Eighty five patients were randomly divided into two groups, EACA group (43) and control group (42). Twenty milliliters of 5% EACA solution or normal saline was perfused into the incision of patients in EACA group and control group, respectively. The volume of post-operative drainage was investigated as the primary outcome. Post-operative blood test, coagulation test, and wound complications were analyzed as the secondary outcomes. Results The volume of post-operative drainage at 24 and 48 h was 164.8 ± 51.4 ml, 18.9 ± 3.8 ml for patients in EACA group, and 373.0 ± 88.1 ml, 21.2 ± 4.4 ml for patients in the control group, respectively. EACA greatly reduced the post-operative blood loss compared to the control (normal saline). The difference between the two groups was statistically significant. No statistically significant difference was found between EACA group and control group with regard to the pre-operative, baseline characteristics. Post-operative blood test results demonstrated that haemoglobin and hematocrit were significantly higher in EACA compared to those of control group. No significant difference was found between EACA group and control group in terms of the platelet counts, prothrombin time (P.T.), activated partial prothrombin time (APTT), and wound complications. Conclusion Local administration of EACA is effective in post-operative blood loss reduction in ORIF surgeries for Sanders III–IV types of calcaneal fractures without increasing the incidence of periwound complication.

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The Effect of Low Doses of Epsilon-Aminocaproic Acid on Blood Loss Following Cardiac Surgery under Cardiopulmonary Bypass

Health and Ecology Issues ◽

10.51523/2708-6011.2019-16-3-13 ◽

2019 ◽

pp. 70-76

Author(s):

D. V. Osipenko ◽

A. A. Skorokhodov ◽

A. A. Silanov

Keyword(s):

Cardiac Surgery ◽

Cardiopulmonary Bypass ◽

Blood Loss ◽

Randomized Study ◽

Aminocaproic Acid ◽

Control Group ◽

Low Doses ◽

Thoracic Drainage ◽

Group 2 ◽

Epsilon Aminocaproic Acid

Objective: to study the effectiveness of the application of low doses of epsilon-aminocaproic acid (EACA) (8-12 g) during cardiac operations under cardiopulmonary bypass (CPB) with the assessment of the effect on blood loss, number of transfusions, complications, and thromboelastometry parameters. Material and methods. The prospective, randomized study included 113 patients undergoing routine cardiac surgery under cardiopulmonary bypass. Two groups were formed: group 1 (n = 51) - an EACA bolus of 75 mg/kg was administered intravenously with titration of 30 mg/kg/h during CPB; group 2 (n = 62) was the control group. Conclusion. The introduction of low doses of EACA (10.2 (8.9; 11.4) g) reduces the thoracic-drainage volume by 30 %, reduces the frequency of donor blood transfusions by 38 % within 36-48 hours after the surgery without increasing the number of complications.

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Effect of ulinastatin on post-operative blood loss and allogeneic transfusion in patients receiving cardiac surgery with cardiopulmonary bypass: a prospective randomized controlled study with 10-year follow-up

10.21203/rs.2.24411/v2 ◽

2020 ◽

Author(s):

Peng Zhang ◽

Hong Lv ◽

Xia Qi ◽

Wenjing Xiao ◽

Qinghua Xue ◽

...

Keyword(s):

Cardiac Surgery ◽

Blood Loss ◽

Heart Surgery ◽

Acid Group ◽

Erythrocyte Transfusion ◽

Operative Blood Loss ◽

Allogeneic Transfusion ◽

Major Morbidity ◽

Randomized Controlled

Abstract Background: Major bleeding and allogeneic transfusion leads to negative outcomes in patients receiving cardiac surgery with cardiopulmonary bypass (CPB). Ulinastatin, a urine trypsin inhibitor, relieves systemic inflammation and improves coagulation profiles with however sparse evidence of its effects on blood loss and allogeneic transfusion in this specific population. Methods: In this prospective randomized controlled trial, 426 consecutive patients receiving open heart surgery with CPB were randomly assigned into three groups to receive ulinastatin (group U, n=142), tranexamic acid (group T, n=143) or normal saline (group C, n=141). The primary outcome was the total volume of post-operative bleeding and the secondary outcome included the volume and exposure of allogeneic transfusion, the incidence of stroke, post-operative myocardial infarction, renal failure, respiratory failure and all-cause mortality. A ten-year follow-up was carried on to evaluate long-term safety.Results: Compared with placebo, ulinastatin significantly reduced the volume of post-operative blood loss within 24 hours (688.39±393.55ml vs 854.33±434.03ml MD -165.95ml, 95%CI -262.88ml to -69.01ml, p<0.001) and the volume of allogeneic erythrocyte transfusion (2.57±3.15 unit vs 3.73±4.21 unit, MD-1.16 unit, 95%CI -2.06 units to -0.26 units, p=0.002). The bleeding and transfusion outcomes were comparable between the ulinastatin group and the tranexamic acid group. In-hospital outcomes and 10-year follow-up showed no statistical difference in mortality and major morbidity among groups. Conclusions: Ulinastatin reduced post-operative blood loss and allogeneic erythrocyte transfusion in heart surgery with CPB. The mortality and major morbidity was comparable among the groups shown by the 10-year follow-up. Trial registration: The trial was retrospectively registered on February 2, 2010. Trial registration number: https://www.clinicaltrials.gov. Identifier: NCT01060189.

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