Novosti
Khirurgii

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Year 2021 Vol. 29 No 5

ANESTHESIOLOGY-REANIMATOLOGY

K.V. BODYAKOV, A.V. MAROCHKOV, A.S. KYLIK, V.A. DUDKO, A.L. LIPNITSKI

SPECIFICITY OF USING TRANEXAMIC ACID IN PATIENTS WITH CARDIAC SURGERY

Mogilev Regional Hospital, Mogivev,
The Republic of Belarus

Objective. To evaluate the efficacy of tranexamic acid (ÒÀ) in cardiac surgery patients undergoing the open-heart surgery under conditions of artificial blood circulation (ÀBC) by determining the volume of perioperative blood loss using the hemoglobin balance method.
Methods. A pilot non-randomized prospective clinical trial was conducted. To determine the effectiveness of TÀ use, 2 groups of patients were formed: the 1st group, without TÀ application (n=40), the 2nd group – with TÀ application intraoperatively (n=40). In group 2, prior to sternotomy, intravenous bolus injection of TA (1000 mg (20 ml of 5% solution)) was performed and further titration of TA through a syringe dispenser was continued at a rate of 4 ml/hour (200 mg/hour) until the end of the operation.The volume of intraoperative blood-loss was assessed by the hemoglobin balance method. A special protocol was developed to control the volume of postoperative blood loss.
Results. The volume of circulating blood (VCB) calculated by Nadler’s formula for the first group was 5433.2 (5008.5; 5768.2) ml, for the second – 5214.0 (4944.1; 5546.8) ml. In the first group of patients who did not receive TA during open- heart surgery, the volume of blood loss was 1460.6 (1196.8; 1725.8) ml or 26.9 % of the average circulating blood volume (CBV), and in the second group of patients who received TA intraoperatively – 1090.7 (882.3; 1468.6) ml or 20.9% of the CBV (p<0,001).
Conclusion. The application of TÀ in cardiac surgery patients during open-heart surgery with ABC according to the developed algorithm (1000 mg/bolus, titration during surgery-200 mg/h) for the purpose of blood saving the volume of blood-loss was reduced by 25.3% compared to the control group.

Keywords: cardiac surgery, tranexamic acid, blood loss, hemoglobin balance, extracorporeal circulation
p. 590-597 of the original issue
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Address for correspondence:
212016, Republic of Belarus,
Mogilev, Belynitskogii-Biruli Str.,
Mogilev Regional Hospital, Intensive Care
Unit of the Center of Cardiovascular Surgery,
tel/fax +375 222 62-90-75,
e-mail: kirill_bodyakov@mail.ru,
Bodyakov Kirill V.
Information about the authors:
Bodyakov Kirill V., Anaesthesiologist of the Intensive Care Unit of the Center of Cardiovascular Surgery, Mogilev Regional Hospital, Mogilev, Republic of Belarus.
https://orcid.org/0000-0003-4639-4079
Marochkov Alexey V., MD, Professor, Anaesthesiologist of the Intensive Care Unit, Mogilev Regional Hospital, Mogilev, Republic of Belarus.
https://orcid.org/0000-0001-5092-8315
Kylik Anatoly S., Cardiac Surgeon, Head Physician, Mogilev Regional Hospital, Mogilev, Republic of Belarus.
https://orcid.org/0000-0001-6663-3802
Dudko Vladimir A., Head of the Intensive Care Unit of the Center of Cardiovascular Surgery, Mogilev Regional Hospital, Mogilev, Republic of Belarus.
https://orcid.org/0000-0002-5959-5454
Lipnitski Artur L., PhD, Head of the Department for Coordinating the Collection of Organs and Tissues for Transplantation, Mogilev Regional Hospital, Mogilev, Republic of Belarus.
https://orcid.org/0000-0002-2556-4801
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