Prophylactic tranexamic acid versus autologous blood transfusion to reduce bleeding in elective coronary bypass graft surgery

الملخص EN

Many blood conservation strategies were developed in the past decades to reduce risk of bleeding and the need for blood products among patients undergoing cardiac surgeries.

This study was conducted to define the benefit of reinfusion of preoperative collected autologous blood in reduction of the risk of bleeding and the need for blood and blood products in comparison with tranexamic acid.

This single centre single-blinded, randomized study was conducted in Erbil cardiac centre during the period from 1st of November 2018 to 30th of April 2019.

A total of 150 patients were divided into three groups with 50 patients for each.

The 1st group received nothing, the 2nd group received initially infusion of 200mg/hr of tranexamic acid until reaching 1.5gm/hr, and the 3rd group received one pint of preoperative auto-transfused whole blood.

Data on risk of bleeding and the need for blood and blood products were collected using special questionnaire prepared for the reason of this study and were analyzed using appropriate statistical tests.

Patients receiving autologous blood showed lower chest tube drainage than the other study groups with a p value of <0.001.

Similarly the need for blood and blood products intra or postoperatively was significantly lower among patients receiving autologous blood with p value of < 0.001.

Therefore, the risk of intra and postoperative bleeding was significantly lower among those receiving autologous blood when compared to other study groups.

In conclusion, reinfusion of one pint of preoperative collected autologous blood is higher than tranexamic acid in reducing the risk of postoperative bleeding and the need for blood and blood products among patients undergoing cardiac surgery.