Institute for Anesthesiology and Pain Therapy, Herz- und Diabeteszentrum Nordrhein-Westfalen, Bad Oeynhausen, Nordrhein-Westfalen, Germany.
Clinic for Thoracic and Cardiovascular Surgery, Herz- und Diabeteszentrum Nordrhein-Westfalen, Bad Oeynhausen, Nordrhein-Westfalen, Germany.
Thorac Cardiovasc Surg. 2024 Jan;72(1):55-58. doi: 10.1055/s-0042-1760205. Epub 2023 Jan 19.
In 873 propensity score-matched pairs of patients undergoing valvular heart surgery, we compared a "moderate dose" of tranexamic acid (TXA) protocol (group 1; median TXA dose: 24 mg/kg body weight) with a 1.5-g "bolus-only" protocol (group 2; median TXA dose: 19 mg/kg body weight). The number of transfused patients was higher in group 2 than in group 1 (74.5 vs 66.0%, < 0.001), as was the number of transfused red blood cell concentrates ( = 0.001). The risks of re-exploration and convulsive seizures were similar between groups ( > 0.50). Data indicate an impaired efficacy following the "bolus-only" protocol, without a significant safety improvement.
在 873 对接受心脏瓣膜手术的患者进行倾向性评分匹配的病例对照研究中，我们比较了“中等剂量”氨甲环酸（TXA）方案（组 1；TXA 剂量中位数：24mg/kg 体重）和 1.5g“仅推注”方案（组 2；TXA 剂量中位数：19mg/kg 体重）。与组 1 相比，组 2 中输注患者的数量更高（74.5%比 66.0%， < 0.001），输注的浓缩红细胞数量也更高（ = 0.001）。两组之间再次探查和惊厥性发作的风险相似（ > 0.50）。数据表明，“仅推注”方案的疗效受损，而安全性无显著改善。
