Journal article
Hemostatic Effects of Tranexamic Acid and Desmopressin During Cardiac Surgery
Circulation (New York, N.Y.), v 84(5), pp 2063-2070
Nov 1991
PMID: 1934382
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
BACKGROUNDDesmopressin-induced release of tissue plasminogen activator from endothelial cells may explain the absence of its hemostatic effect in patients undergoing cardiac surgery. Prior administration of the antifibrinolytic drug tranexamic acid might unmask such an effect, and combination therapy might thereby improve postoperative hemostasis.
METHODS AND RESULTSA double-blinded design randomly allocated 163 adult patients undergoing coronary revascularization, valve replacement, both procedures, or repair of atrial septal defect to four treatment groupsplacebo, tranexamic acid given as 10 mg/kg over 30 minutes followed by 1 mg. kg. hr for 12 hours initiated before skin incision, desmopressin given as 0.3 μg/kg over 20 minutes after protamine infusion, and both drugs. One surgeon performed all operations. Blood loss consisted of mediastinal tube drainage over 12 hours. Follow-up visits sought evidence of myocardial infarction and stroke. Desmopressin decreased neither the 12-hour blood loss nor the amount of homologous red cells transfused. Tranexamic acid alone significantly reduced 12-hour blood loss, by 30%1 (mean, 318 versus 453 ml;
CONCLUSIONSDesmopressin exerts no hemostatic effect, with or without prior administration of antifibrinolytic drug. Prophylactic tranexamic acid alone appears economical and safe in decreasing blood loss and transfusion requirement after cardiac surgery.
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Details
- Title
- Hemostatic Effects of Tranexamic Acid and Desmopressin During Cardiac Surgery
- Creators
- Jan Horrow - Hahnemann University HospitalDaniel Van Riper - Hahnemann University HospitalMichael Strong - Hahnemann University HospitalIsadore Brodsky - Hahnemann University HospitalJonathan Parmet - Hahnemann University HospitalJay C Horrow - Anesthesiology and Perioperative Medicine
- Publication Details
- Circulation (New York, N.Y.), v 84(5), pp 2063-2070
- Publisher
- by the American College of Cardiology Foundation and the American Heart Association, Inc
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Anesthesiology and Perioperative Medicine
- Web of Science ID
- WOS:A1991GN52200021
- Scopus ID
- 2-s2.0-0026005804
- Other Identifier
- 991019184099604721
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InCites Highlights
Data related to this publication, from InCites Benchmarking & Analytics tool:
- Web of Science research areas
- Cardiac & Cardiovascular Systems
- Peripheral Vascular Disease