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Original ArticleOpen Access
Tranexamic Acid as a Means of Reducing the Need for Blood and Blood Component Therapy in Children Under going Open Heart Surgery for Congenital Cyanotic Heart Disease
Vacharaksa K 
,
Suksompong S ,
Prakanrattana U ,
Chumpathong S
,
Suksompong S ,
Prakanrattana U ,
Chumpathong S UNGKAB PRAKANRATTANA, M.D.*,
SAOWAPARK CHUMPATHONG, M.D.*
Children undergoing cardiac operations using cardiopulmonary bypass (CPB) are at risk
of significant postoperative bleeding and the need for transfusion. The antifibrinolytic drug, tran-
examic acid, decreases blood loss in adult patients undergoing cardiac surgery. However, its efficacy
has not been extensively studied in patients with cyanotic congenital heart defects (CHD). Using a
prospective, randomized, double-blind study design, we examined 67 children undergoing repair of
cyanotic CHD. After induction of anesthesia and prior to skin incision, patients received 15 mglkg
of tranexamic acid intravenously. At the end of CPB, a second bolus of tranexamic acid (15 mglkg)
or saline placebo was administered. Postoperative blood loss and transfusion requirements from the
period after protamine administration until 24 hours after admission to the intensive care unit were
recorded. In addition, the hematocrit, platelet count and other indices of coagulation were recorded
every 6 hours. There was no significant difference in postoperative blood loss between the treated
and the placebo group (12.51
เธ‘
13.20 ml/kg per 24 hours, in the tranexamic acid group,
vs
10.68
เธ‘
6.38 ml/kg per 24 hours, in the placebo group). Also there was no significant difference in the
amounts of blood and blood products administered between the two groups. No adverse effects of
tranexamic acid were found in this study.
In conclusion, there was no significant difference in postoperative blood loss or blood
and blood product requirement between those children with cyanotic CHD undergoing open heart
surgery who received a single dose of tranexamic acid compared with those who received two
doses.
Key word : Tranexamic Acid, Cyanotic Heart Disease, Open Heart Surgery, Postoperative Blood
I
Component Use
SAOWAPARK CHUMPATHONG, M.D.*
Children undergoing cardiac operations using cardiopulmonary bypass (CPB) are at risk
of significant postoperative bleeding and the need for transfusion. The antifibrinolytic drug, tran-
examic acid, decreases blood loss in adult patients undergoing cardiac surgery. However, its efficacy
has not been extensively studied in patients with cyanotic congenital heart defects (CHD). Using a
prospective, randomized, double-blind study design, we examined 67 children undergoing repair of
cyanotic CHD. After induction of anesthesia and prior to skin incision, patients received 15 mglkg
of tranexamic acid intravenously. At the end of CPB, a second bolus of tranexamic acid (15 mglkg)
or saline placebo was administered. Postoperative blood loss and transfusion requirements from the
period after protamine administration until 24 hours after admission to the intensive care unit were
recorded. In addition, the hematocrit, platelet count and other indices of coagulation were recorded
every 6 hours. There was no significant difference in postoperative blood loss between the treated
and the placebo group (12.51
เธ‘
13.20 ml/kg per 24 hours, in the tranexamic acid group,
vs
10.68
เธ‘
6.38 ml/kg per 24 hours, in the placebo group). Also there was no significant difference in the
amounts of blood and blood products administered between the two groups. No adverse effects of
tranexamic acid were found in this study.
In conclusion, there was no significant difference in postoperative blood loss or blood
and blood product requirement between those children with cyanotic CHD undergoing open heart
surgery who received a single dose of tranexamic acid compared with those who received two
doses.
Key word : Tranexamic Acid, Cyanotic Heart Disease, Open Heart Surgery, Postoperative Blood
I
Component Use
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