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

Objective: This study was designed to evaluate the hemostatic effect of tranexamic acid in off-pump coronary artery bypass surgery. Design: A prospective, randomized, double-blind, placebo-controlled study. Setting: The Department of Anesthesiology and Cardiac Surgery, Medical Sciences University. Participants: One hundred eight patients undergoing off-pump coronary artery bypass surgery were enrolled into the study. Eight patients were withdrawn, and 100 patients were divided into 2 groups. Interventions: Fifty patients received tranexamic acid (bolus 1 g before skin incision and followed by maintenance dose of 400 mg/h during surgery), and 50 patients received saline. Measurement and Main Results: Hematologic parameters, volume of blood loss, blood transfusion, and other clinical data were recorded throughout the perioperative period. Twenty-four-hour postoperative blood loss was significantly less in the tranexamic acid group compared with the control group (471 +/- 182 v 844 +/- 303). Patients in the tranexamic acid group received significantly less allogeneic blood (8 v 31 units). Conclusion: Bleeding and hemorrhagic complications and the consequent need for allogeneic transfusion are still major problems after off-pump coronary artery bypass surgery. Tranexamic acid appears to be effective in reducing postoperative bleeding and the need for allogeneic blood products. (C) 2009 Elsevier Inc. All rights reserved.