Efficacy and Safety of Tropical Use of Tranexamic Acid during Off-Pump Coronary Artery Bypass Surgery: A Randomized Control Trial

Authors

  • Asraful Hoque Associate Professor, Department of Cardiac Surgery, National Institute of Cardiovascular Diseases, Dhaka, Bangladesh
  • Tasmin Rubayath Medical officer, Department of Clinical Pathology; Dhaka Medical College Hospital, Dhaka
  • Romena Rahman Assistant Professor, Department of Cardiac Surgery, National Institute of Cardiovascular Diseases, Dhaka, Bangladesh
  • Md Tanvir Hossain Assistant Register, Department of Cardiac Surgery, National Institute of Cardiovascular Diseases, Dhaka, Bangladesh
  • Abu Shadat Mohammad Saem Khan Assistant Register, Department of Cardiac Surgery, National Institute of Cardiovascular Diseases, Dhaka, Bangladesh
  • Monzur Hossain Assistant Register, Department of Cardiac Surgery, National Institute of Cardiovascular Diseases, Dhaka, Bangladesh
  • Muhammad Asif Ahsan Chowdhury Assistant Register, Department of Cardiac Surgery, National Institute of Cardiovascular Diseases, Dhaka, Bangladesh
  • Imran Ahmed Assistant Register, Department of Cardiac Surgery, National Institute of Cardiovascular Diseases, Dhaka, Bangladesh
  • Wahida Salam Assistant Register, Department of Cardiac Surgery, National Institute of Cardiovascular Diseases, Dhaka, Bangladesh

DOI:

https://doi.org/10.3329/jninb.v7i2.58109

Keywords:

Post-Operative Outcomes; Off-Pump; Coronary Artery Bypass Surgery; Tranexamic Acid

Abstract

Background: Postoperative mediastinal bleeding in patients undergoing cardiac surgery is still one of the most common complications.

Objective: This study was intended to investigate the efficacy of topical tranexamic acid in reducing postoperative bleeding after post-operative cardiovascular surgery.

Methodology: In this non-randomized, double blinded, clinical trial, patients undergoing Off-Pump Coronary Artery Bypass (OPCAB) surgery in NICVD, Dhaka, Bangladesh during January 2014 to December 2015 and fulfilling inclusion and exclusion criteria were recruited. They were assigned in two groups- 30 patients in tranexamic acid group (Group 1) and 30 patients in placebo group (Group 2). On completion of the grafting, before closure of the sternum tranexamic acid (2.5 g/25 mL) or placebo (25 mL of saline) diluted in 100 mL of warm saline (370 C) was instilled into the pericardial cavity including the mediastinal tissues and left for 5 minutes. Then it was cleared out by wall sucker and sternum was closed.

Results: There was no significant difference in baseline demographic data, basic clinical characteristics and preoperative coagulation profile between the 2 groups (P > 0.05). Total mediastinal bleeding in group 1 and group 2 patients were421.67±70.32 vs 593.33±77.38ml, p<0.001. In case of, whole blood transfusion in group 1 and group 2 patients were 0.87±0.0.73 units and1.77±0.57 units respectively, p<0.001.

Conclusion: No patient required reoperation for bleeding and there was no incidence of prolonged ventilation, MI, thromboembolism, DVT or CVA in any of the patients in either group.

Journal of National Institute of Neurosciences Bangladesh, July 2021, Vol. 7, No. 2, pp. 142-146 

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Published

2022-02-06

How to Cite

Hoque, A. ., Rubayath, T. ., Rahman, R., Hossain, M. T. ., Saem Khan, A. S. M. ., Hossain, M. ., Ahsan Chowdhury, M. A. ., Ahmed, I., & Salam, W. (2022). Efficacy and Safety of Tropical Use of Tranexamic Acid during Off-Pump Coronary Artery Bypass Surgery: A Randomized Control Trial. Journal of National Institute of Neurosciences Bangladesh, 7(2), 142–146. https://doi.org/10.3329/jninb.v7i2.58109

Issue

Vol. 7 No. 2 (2021)

Section

Original Research Articles

License

Copyright (c) 2022 Asraful Hoque, Tasmin Rubayath, Romena Rahman, Md Tanvir Hossain, Abu Shadat Mohammad Saem Khan, Monzur Hossain, Muhammad Asif Ahsan Chowdhury, Imran Ahmed, Wahida Salam

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