Efficiency Estimation of Various Doses of Tranexamic Acid in Cardiopulmonary Bypass Surgery

Q4 Medicine Novosti Khirurgii Pub Date : 2020-04-24 DOI:10.18484/2305-0047.2020.2.133
D. V. Osipenko, S. P. Salivonchik, A. A. Skarakhodau, A. Silanau, A. Marochkov
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Abstract

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 2 nd 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; 3 rd 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 1 st , 2 nd and 3 rd 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 2 nd and 3 rd 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 1 st group (475.0 (350.0; 650.0) ml) and the 2 nd group (500.0 (350.0; 550.0) ml), compared with the 3 rd group (600.0 (500.0; 750.0) ml). The use of TA in the 2 nd group of patients, compared with the 3 rd group, led to the decrease in the frequency of blood transfusions in the first 42-48 hours after surgery. In the 1 st group of patients, statistically significant differences in the frequency of blood transfusions were not found. 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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体外循环手术中不同剂量氨甲环酸的疗效评价
目标。目的探讨不同剂量氨甲环酸(TA)在体外循环手术(CPB)中的应用效果。方法。该研究包括128名接受CPB心脏手术的患者。实验分为三组:第一组(n=30), TA负荷剂量为10mg /kg, CPB期间滴注剂量为1mg /kg/h;第二组(n=32) -静脉注射TA的负荷剂量- 12.5 mg/kg并滴定- CPB期间6.5 mg/kg/h,术后前6小时1 mg/kg/h;第三组(n=66) -对照组。结果。1、2、3组患者手术开始至术后42 ~ 48 h失血量分别为:20.9 (18.1;26.7) ml/kg, 19.3 (13.9;22.5) ml/kg和22.8 (18.4;27.6) ml/ kg;只有第2组和第3组患者有统计学差异。第1组术后42 ~ 48小时胸管引流总容积显著低于第1组(475.0;650.0) ml)和第二组(5000.0 (350.0;550.0) ml),与第三组(600.0 (500.0;750.0毫升)。与第3组患者相比,第2组患者使用TA导致术后42-48小时内输血次数减少。第一组患者输血次数差异无统计学意义。CPB期间剂量为6.5 mg/kg/h,术后前6小时剂量为1 mg/kg/h(总剂量为2.5 (2.1;3.0) g)在体外循环心脏手术中最为理想。
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Novosti Khirurgii
Novosti Khirurgii Medicine-Surgery
CiteScore
0.50
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0.00%
发文量
15
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