Intraoperative Use of Epsilon Amino Caproic Acid and Tranexamic Acid in Surgeries Performed Under Cardiopulmonary Bypass a Comparative Study To Assess Their Impact On Reopening Due To Postoperative Bleeding

Abstract

BACKGROUND: Open heart surgeries under cardiopulmonary bypass are associated with excessiveperioperative bleeding that often requires reoperation. Antifibrinolytics like epsilon aminocaproic acidand tranexamic acid are widely used to control bleeding. There are limited studies primarily showing theimpact of these drugs on the incidence of reopening following open heart surgical procedures. The goalof this study was to compare incidence of reopening following open heart surgeries in patients who wereadministered either epsilon amino caproic acid or tranexamic acid for control of perioperative bleeding.METHODS: A prospective, randomized, controlled trial was performed among seventy-eight patients ofeither sex in the age group of 18 to 65 years scheduled for open heart surgeries under cardiopulmonarybypass. They were randomly allocated into three groups where group A (n=26) received epsilonaminocaproic acid, group B (n=26) received tranexamic acid and group C (control group, n=26) receivedintravenous 0.9% normal saline. Patients had similar anaesthetic protocols, and were monitored fortwenty-four hours postoperatively to assess reopening rates because of excessive bleeding.RESULTS: Two patients in each group receiving either tranexamic acid or epsilon aminocaproic acidhad excessive bleeding requiring reopening after surgery whereas three patients in the control group hadundergone reopening for excessive bleeding (p>0.05).CONCLUSIONS: Epsilon aminocaproic acid and tranexamic acid exhibit similar and comparable effectto placebo on incidence of reopening for excessive bleeding following open heart surgeries undercardiopulmonary bypass