This journal is
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Year 2020 Vol. 28 No 2
GENERAL & SPECIAL SURGE
D.V. OSIPENKO 1, S.P. SALIVONCHIK 1, A.A. SKARAKHODAU 1, A.A. SILANAU 1, A.V. MAROCHKOV 2
EFFICIENCY ESTIMATION OF VARIOUS DOSES OF TRANEXAMIC ACID IN CARDIOPULMONARY BYPASS SURGERY
Gomel Regional Clinical Cardiological Center 1, Gomel,
Mogilev Regional Hospital 2, Mogilev,
The Republic of Belarus
Objective. To determine the effectiveness of various doses of tranexamic acid (TA) in the cardiopulmonary bypass surgery (CPB).
Methods. The study included 128 patients who underwent the heart surgery with CPB. Three groups were formed: group 1 (n=30) – a loading dose of TA – 10 mg/kg was administered intravenously with titration – 1 mg/kg/h during CPB; the 2nd group (n=32) – a loading dose of TA was administered intravenously – 12.5 mg/kg with titration – 6.5 mg/kg/h during CPB and 1 mg/kg/h in the first 6 hours after surgery; 3rd group (n=66) – the control one.
Results. The blood loss volume during the period from the operation onset to 42 – 48 hours after it, in the 1st, 2nd and 3rd group of patients was: 20.9 (18.1; 26.7) ml/kg, 19.3 (13.9; 22.5) ml/kg and 22.8 (18.4; 27.6) ml/kg; statistically significant differences were only between the 2nd and 3rd group of patients. The total volume of the chest tube drainage in the first 42-48 hours after the operation was significantly less in the 1st group (475.0 (350.0; 650.0) ml) and the 2nd group (500.0 (350.0; 550.0) ml), compared with the 3rd group (600.0 (500.0; 750.0) ml). The use of TA in the 2nd group of patients, compared with the 3rd group, led to the decrease in the frequency of blood transfusions in the first 42-48 hours after surgery. In the 1st group of patients, statistically significant differences in the frequency of blood transfusions were not found.
Conclusions. Maintenance of TA according to the method – the bolus of 12.5 mg/kg, titration of 6.5 mg/kg/ h during CPB and 1 mg/kg/h in the first 6 hours after surgery (total dose of 2.5 (2.1; 3.0) g) is optimal in the cardiopulmonary bypass heart surgery.
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246046, Republic of Belarus,
Gomel, Meditsinskaya Str., 4,
Gomel Regional Clinical Cardiological Center,
Department of Anesthesiology and Intensive Care
With the Intensive Care Wards.
Tel.: +375 29 614 65 98,
Dzmitry V. Osipenko
Osipenko Dzmitry V., PhD, Anesthesiologist-Resuscitator, the Department of Anesthesiology and Intensive Care with the Intensive Care Wards, Gomel Regional Clinical Cardiological Center, Gomel, Republic of Belarus.
Salivonchik Sergey A., PhD, Cardiac Surgeon, Deputy Chief Physician for Surgical Care, Gomel Regional Clinical Cardiological Center, Gomel, Republic of Belarus.
Silanau Aliaksandr A., Anesthesiologist-Resuscitator, the Department of Anesthesiology and Intensive Care with the Intensive Care Wards, Gomel Regional Clinical Cardiological Center, Gomel, Republic of Belarus.
Skarakhodau Aliaksandr A., Cardiac Surgeon, the Cardiac Surgery Unit, Gomel Regional Clinical Cardiological Center, Gomel, Republic of Belarus.
Marochkov Alexey V., MD, Anesthesiologist-Resuscitator, Mogilev Regional Hospital, Mogilev, Republic of Belarus.