| A double-blind, placebo-controlled trial of epsilon-aminocaproic acid for reducing blood loss in coronary artery bypass grafting surgery. | |
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MedLine Citation:
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PMID: 16427545 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Epsilon-aminocaproic acid is a plasmin inhibitor that potentially reduces perioperative bleeding when administered prophylactically to cardiac surgery patients. To evaluate the efficacy of epsilon-aminocaproic acid, a prospective placebo-controlled trial was conducted in patients undergoing primary coronary artery bypass grafting surgery. STUDY DESIGN: One hundred patients were randomly assigned to receive either epsilon-aminocaproic acid (100 mg/kg before skin incision followed by 1 g/hour continuous infusion until chest closure, 10 g in cardiopulmonary bypass circuit) or placebo, and the efficacy of epsilon-aminocaproic acid was evaluated by the reduction in postoperative thoracic-drainage volume and in donor-blood transfusion up to postoperative day 12. RESULTS: Postoperative thoracic-drainage volume was significantly lower in the epsilon-aminocaproic acid group compared with the placebo group (epsilon-aminocaproic acid, 649 +/- 261 mL; versus placebo, 940 +/- 626 mL; p=0.003). There were no significant differences between the epsilon-aminocaproic acid and placebo groups in the percentage of patients requiring donor red blood cell transfusions (epsilon-aminocaproic acid, 24%; versus placebo, 18%; p=0.62) or in the number of units of donor red blood cells transfused (epsilon-aminocaproic acid, 2.2 +/- 0.8 U; versus placebo, 1.9 +/- 0.8 U; p=0.29). Epsilon-aminocaproic acid did not reduce the risk of donor red blood cell transfusions compared with placebo (odds ratio: 1.2, 95% confidence interval; 0.4 to 3.2, p=0.63). CONCLUSIONS: Prophylactic administration of epsilon-aminocaproic acid reduces postoperative thoracic-drainage volume by 30%, but it may not be potent enough to reduce the requirement and the risk for donor blood transfusion in cardiac surgery patients. This information is useful for deciding on a therapy for hemostasis in cardiac surgery. |
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Authors:
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Mutsuhito Kikura; Jerrold H Levy; Kenichi A Tanaka; James G Ramsay |
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Publication Detail:
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Type: Journal Article; Randomized Controlled Trial Date: 2005-12-19 |
Journal Detail:
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Title: Journal of the American College of Surgeons Volume: 202 ISSN: 1072-7515 ISO Abbreviation: J. Am. Coll. Surg. Publication Date: 2006 Feb |
Date Detail:
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Created Date: 2006-01-23 Completed Date: 2006-03-10 Revised Date: 2006-08-07 |
Medline Journal Info:
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Nlm Unique ID: 9431305 Medline TA: J Am Coll Surg Country: United States |
Other Details:
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Languages: eng Pagination: 216-22; quiz A44-5 Citation Subset: AIM; IM |
Affiliation:
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Department of Anesthesiology, Emory University School of Medicine, Emory University Hospital, The Emory Clinic, Atlanta, GA, USA. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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6-Aminocaproic Acid
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therapeutic use* Adult Aged Antifibrinolytic Agents / therapeutic use* Blood Loss, Surgical / prevention & control* Blood Transfusion / statistics & numerical data Coronary Artery Bypass* Double-Blind Method Female Humans Male Middle Aged |
| Chemical | |
Reg. No./Substance:
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0/Antifibrinolytic Agents; 60-32-2/6-Aminocaproic Acid |
| Comments/Corrections | |
Comment In:
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Evid Based Cardiovasc Med. 2006 Jun;10(2):149-51
[PMID:
16753544
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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