Can local application of Tranexamic acid reduce post-coronary bypass surgery?
Fawzy H, Elmistekawy E, Bonneau D, et al. Journal of Cardiothoracic Surgery 2009;4: 25 Reviewers Nana Benneh, MD Nanhi Mitter, MD Johns Hopkins Hospital Baltimore, MD Abstract Excerpt In an effort to reduce postoperative blood loss, Fawzy et al report a prospective, randomized controlled study comparing the topical application of tranexamic acid to placebo. 38 patients undergoing primary isolated coronary bypass grafting were randomized to either the placebo or to the treatment group. Exclusion criteria included repeat surgery, combined procedures, patients with a history of hemophilia or with a platelet count < 100, and patients who have received heparin within 48 hours or antiplatelet drugs < 7 days preoperatively. The tranexamic acid was placed in the pericardial and mediastinal cavities prior to chest closure (with the chest tubes clamped). Cumulative blood loss, blood component transfusion, and morbidity and mortality were the primary outcome measures. No significant differences w
