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Risk factors associated with postoperative seizures in patients undergoing cardiac surgery who received tranexamic acid: A case-control study.
MedLine Citation:
PMID:  22234015     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
Antifibrinolytic agents are used during cardiac surgery to minimize bleeding and reduce exposure to blood products. Several reports suggest that tranexamic acid (TA) can induce seizure activity in the postoperative period. To examine factors associated with postoperative seizures in patients undergoing cardiac surgery who received TA. University-affiliated hospital. Case-control study. Patients undergoing cardiac surgery with cardiopulmonary bypass (CPB) between January 2008 and December 2009 were identified. During this time, all patients undergoing heart surgery with CPB received TA. Cases were defined as patients who developed seizures that required initiation of anticonvulsive therapy within 48 h of surgery. Exclusion criteria included subjects with preexisting epilepsy and patients in whom the convulsive episode was secondary to a new ischemic lesion on brain imaging. Controls who did not develop seizures were randomly selected from the initial cohort. From an initial cohort of 903 patients, we identified 32 patients with postoperative seizures. Four patients were excluded. Twenty-eight cases and 112 controls were analyzed. Cases were more likely to have a history of renal impairment and higher preoperative creatinine values compared with controls (1.39 ± 1.1 vs. 0.98 ± 0.02 mg/dL, P = 0.02). Significant differences in the intensive care unit, postoperative and total lengths of stay were observed. An association between high preoperative creatinine value and postoperative seizure was identified. TA may be associated with the development of postoperative seizures in patients with renal dysfunction. Doses of TA should be reduced or even avoided in this population.
Authors:
Felix R Montes; Daniel F Pardo; Marisol Carreño; Catalina Arciniegas; Rodolfo J Dennis; Juan P Umaña
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Annals of cardiac anaesthesia     Volume:  15     ISSN:  0974-5181     ISO Abbreviation:  Ann Card Anaesth     Publication Date:  2012 Jan 
Date Detail:
Created Date:  2012-01-11     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9815987     Medline TA:  Ann Card Anaesth     Country:  India    
Other Details:
Languages:  eng     Pagination:  6-12     Citation Subset:  IM    
Affiliation:
Department of Anaesthesiology, Fundacion CardioInfantil, Instituto de Cardiologia, Bogota, Colombia, South America.
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