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Interactive Cardiovascular and Thoracic Surgery 3:489-494(2004)
© 2004 European Association of Cardio-Thoracic Surgery

Best evidence topic - Cardiac general

Does prophylactic tranexamic acid safely reduce bleeding without increasing thrombotic complications in patients undergoing cardiac surgery?

Sundaramoorthi Thiagarajamurthya, Adrian Levinea and Joel Dunningb,*

a Department of Cardiothoracic Surgery, North Staffordshire Royal Infirmary, Stoke, UK
b Department of Cardiothoracic Surgery, Freeman Hospital, Newcastle-upon-Tyne NE7 7DN, UK

moorti{at}hotmail.com

adrian_levine{at}hotmail.com

* Corresponding author. Tel.: +44-780-1548122
joeldunning{at}doctors.org.uk

A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was whether prophylactic tranexamic acid can safely reduce bleeding without increasing thrombotic complications in patients undergoing cardiac surgery. Altogether 334 papers were found using the reported search, of which 12 represented the best evidence on this topic. The author, journal, date and country of publication, patient group studied, study type, relevant outcomes, results, and study weaknesses were tabulated. We conclude that tranexamic acid clearly reduces blood loss, requirement for blood transfusion, and the risk of reoperation for bleeding, and although no study has yet looked directly at vein graft patency with tranexamic acid, no randomized studies have raised concerns over its safety.

Key Words: Evidence-based medicine; Tranexamic acid; Thoracic surgery; Cardiopulmonary bypass; Post-operative complications; Review

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