The Efficacy and Safety of a Low-Dose Tranexamic Acid Bolus-Only Protocol Compared with the Moderate-Dose Protocol in Valvular Heart Surgery.
Andreas KosterNikolai HuldeMarcus-Andre DeutschJan F GummertVera von DossowZittermann ArminPublished in: The Thoracic and cardiovascular surgeon (2023)
In 873 propensity score-matched pairs of patients undergoing valvular heart surgery, we compared a "moderate dose" of tranexamic acid (TXA) protocol (group 1; median TXA dose: 24 mg/kg body weight) with a 1.5-g "bolus-only" protocol (group 2; median TXA dose: 19 mg/kg body weight). The number of transfused patients was higher in group 2 than in group 1 (74.5 vs 66.0%, p < 0.001), as was the number of transfused red blood cell concentrates ( p = 0.001). The risks of re-exploration and convulsive seizures were similar between groups ( p > 0.50). Data indicate an impaired efficacy following the "bolus-only" protocol, without a significant safety improvement.
Keyphrases
- body weight
- red blood cell
- randomized controlled trial
- low dose
- atrial fibrillation
- patients undergoing
- minimally invasive
- coronary artery bypass
- ejection fraction
- end stage renal disease
- high intensity
- newly diagnosed
- high dose
- aortic valve
- prognostic factors
- risk assessment
- big data
- percutaneous coronary intervention
- human health