Tranexamic Acid Reduces Blood Loss in Off-Pump Coronary Artery Bypass Surgery

Tranexamic Acid for Routine Use in Off-Pump Coronary Artery Bypass Surgery

“…As a result, this raises questions of the simplistic assumption that antifibrinolytics will lead to a reduction in adverse events through attenuation of blood loss. 44 The study by Wang and colleagues affirmed that tranexamic acid can reduce the risk of blood exposure in OPCAB, and this confirms the results by Tagghadomi et al 3 and the meta-analysis of previous randomized trials. 11 However, this preliminary knowledge of modest impact on blood loss should not be taken as sufficient to warrant uptake into routine practice.…”

“…[3][4][5][6][7][8][9][10] Each of these randomized trials compared tranexamic acid with placebo or inactive control, and each measured blood loss or transfusions as a primary endpoint. Only 1 of the 8 trials of tranexamic in OPCAB found a significant reduction in the risk of allogeneic blood product exposure.…”

“…Only 1 of the 8 trials of tranexamic in OPCAB found a significant reduction in the risk of allogeneic blood product exposure. 3 Synthesis of these 8 small randomized trials through meta-analysis showed a significant overall reduction in allogeneic transfusion (risk ratio 0.47; 95% confidence interval [CI], 0.33 to 0.66; P Ͻ 0.0001). 11 However, none of the trials adequately reported the risk of clinically important events such as stroke, myocardial infarction, venous thromboembolism, and need for surgical re-exploration for bleeding.…”

Antifibrinolytic Therapy for Perioperative Blood Conservation in Lower-Extremity Primary Total Joint Arthroplasty

“…Administration of intravenous tranexamic acid in particular is viewed as a cost-effective way to reduce blood loss during and after high-risk surgical procedures 6 . Tranexamic acid has been used not only for total joint arthroplasty but also for cardiovascular interventions, with numerous investigators having made important contributions to the current pharmacologic and clinical outcomes research supporting the perioperative use of this antifibrinolytic agent [7][8][9][10] .…”

2011 ACCF/AHA Guideline for Coronary Artery Bypass Graft Surgery: Executive Summary

“…Digoxin and nondihydropyridine calcium channel blockers can be useful to control the ventricular rate in the setting of AF but are not indicated for prophylaxis(265). (Level of Evidence: B) Lysine analogues are useful intraoperatively and postoperatively in patients undergoing on-pump CABG to reduce perioperative blood loss and transfusion requirements(431)(432)(433)(434)(435)(436)(437)(438). (Level of Evidence: A) 2.…”