Department of Anesthesia and Surgical Intensive Care, Faculty of Medicine, Mansoura University, Mansoura, Egypt.
Department of Cardiothoracic Surgery, Faculty of Medicine, Mansoura University, Mansoura, Egypt.
Ann Card Anaesth. 2021 Jan-Mar;24(1):17-23. doi: 10.4103/aca.ACA_84_19.
Pediatric patients are at risk for bleeding after cardiac surgery. Administration of antifibrinolytic agents reduces postoperative blood loss.
Evaluation of the efficacy of combined administration of tranexamic acid (TXA) and ethamsylate in the reduction of postoperative blood loss in pediatric cardiac surgery.
This prospective randomized study included 126 children submitted for cardiac surgery, and they were allocated into three groups: control group (n = 42); TXA group (n = 42):- received only TXA; and combined ethamsylate TXA group (n = 42):- received a combination of TXA and ethamsylate. The main collected data included sternal closure time, the needs for intraoperative transfusion of blood and its products, the total amount of blood loss, and the amount of the whole blood and its products transfused to the patients in the first 24 postoperative hours.
Blood loss volume in the first 24 postoperative hours was significantly smaller in combined group than the TXA and control groups and was significantly smaller in the TXA group than the control group. The sternal closure time was significantly shorter in the combined group than the other 2 groups and significantly shorter in TXA than the control group. The amount of whole blood transfused to patients in the combined group during surgery and in the first postoperative 24 h was significantly smaller than the other 2 groups and smaller in TXA group than the control group during surgery.
Combined administration of ethamsylate and TXA in pediatric cardiac surgery was more effective in reducing postoperative blood loss and whole blood transfusion requirements than the administration of TXA alone.
儿科患者在心脏手术后有出血的风险。使用抗纤维蛋白溶解剂可减少术后失血。
评估联合使用氨甲环酸（TXA）和止血芳酸减少儿科心脏手术术后失血的效果。
这项前瞻性随机研究纳入了 126 名接受心脏手术的儿童，并将其分为三组：对照组（n = 42）；TXA 组（n = 42）：仅接受 TXA；联合止血芳酸 TXA 组（n = 42）：联合使用 TXA 和止血芳酸。主要收集的数据包括胸骨闭合时间、术中输血及其制品的需求、总失血量以及术后 24 小时内患者输注的全血及其制品量。
术后 24 小时内的失血量在联合组中明显小于 TXA 组和对照组，在 TXA 组中明显小于对照组。联合组的胸骨闭合时间明显短于其他两组，在 TXA 组中明显短于对照组。联合组在手术期间和术后 24 小时内输注给患者的全血量明显小于其他两组，在 TXA 组中明显小于对照组。
与单独使用 TXA 相比，在儿科心脏手术中联合使用止血芳酸和 TXA 更能有效减少术后失血和全血输注需求。
