Saignement après circulation extracorporelle et acide epsilon amino-caproïque

Saussine, M.; Delpech, Salvador García; Allien, M.; D, Grolleau; Daures, Mathilde; Coulon, Paul; Chaptal, P.A.

doi:10.1016/s0750-7658(85)80269-0

Cited by 6 publications

(1 citation statement)

References 14 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…No hemostatic salutary effect accompanied desmopressin for elective procedures in children [4] or adult aortocoronary bypass grafting [5,6]. Lysine analog plasmin-plasminogen inhibitors (antifibrinolytics) also have provided varied results [7,8,9,10,11,12,13]. Several trials of the lysine analog E-aminocaproic acid were neither randomized nor blinded [7][8][9]111.…”

Section: Introductionmentioning

confidence: 99%

Effect of tranexamic acid on platelet ADP during extracorporeal circulation

1991

View full text Add to dashboard Cite

Seventeen adults received the antifibrinolytic drug tranexamic acid during cardiac surgery utilizing extracorporeal circulation (ECC). In 8 patients, drug administration began prior to skin incision (pre-ECC); infusions commenced after ECC and protamine administration in another 9 patients (post-ECC). Compared with the post-ECC group, the pre-ECC group exhibited less bleeding via mediastinal drains (420 vs. 655 mL/12 h median, P = 0.024), decreased frequency of the presence (greater than or equal to 10 micrograms/mL) of fibrin split products (P less than 0.05), and greater platelet dense granule content of adenosine diphosphate after surgery (15.47 vs. 4.05 nmoles/mg protein median, P = 0.021). Follow-up in vitro study of tranexamic acid inhibition of plasmin-induced platelet activation utilizing normal human platelet rich plasma and porcine plasmin revealed a 13-fold lower concentration of tranexamic acid for 50% inhibition when plasmin was preincubated with the drug (1.2 micrograms/mL, 95% CI = 1.13-1.60 micrograms/mL) compared to when platelet rich plasma was preincubated with the drug (16 micrograms/mL, 95% CI = 7.3-99. micrograms/mL). Plasmin inactivated with tranexamic acid retained its ability to inhibit thrombin-induced platelet activation, thus suggesting that tranexamic acid inhibits plasmin's catalytic activity and not its binding to platelets. Both clot lysis and platelet dysfunction may contribute to bleeding after ECC. Tranexamic acid blocks plasmin-induced partial platelet activation during ECC, thus preserving platelet function and promoting hemostasis after ECC.

show abstract