The Efficacy of Tranexamic Acid versus Placebo in Decreasing Blood Loss in Infant Undergoing Cardiac Surgery

Objective:To examine the benefits,risks associated with tranexamic acid in infants(10 kg) undergoing low complexity procedures such as the repair of ventricular septal defect(ASD) or atrial septal defect(VSD).Methods: In a prospective,randomized,blind study,80 infants,age1 year old,with no cyanotic disease such as ASD or VSD undergoing cardiac surgery were investigated.In Group one(n=40) patients acted as control and received normal saline.In Group two(n=40) patients received tranexamic acid(30 mg·kg-1 after induction of anesthesia,30 mg·kg-1 in the pump prime and 30 mg·kg-1after weaning from bypass).Postoperately,total mediastinal chest drainage and transfusion requirements at 24 hours were recorded.Test of coagulation including fibrinogen,fibrin degradation products D-dimer levels and platelet counts before and after operation were perfomed and data were also analyzed and recorded.Results: postoperative blood lose was significantly higher in the control group(Group one)compared with the drug treated group(Group two)(11.9±9.3 mL·kg-1 and 9.0±4.8 mL·kg-1,P0.05),and the patients on treatment have 24% less bleeding in the first 24 hours after surgery.The total transfusion requirements were no less in the treatment group.D-dimer levels were lower in the treatment group,the other coagulation paraments were not found to be significantly different between the two groups.Conclusions: Our results suggested that tranexamic acid totally dose about 90 mg·kg-1was effective to inhibit fibrinolysis and reduce postoperative bleeding in the infants undergoing no complexity cardiac surgery with cardiopulmonary bypass.And no adverse effects attributable to the treatment were observed.