Yıl 2020, Cilt 4 , Sayı 4, Sayfalar 309 - 313 2020-04-01

Impact of tranexamic acid on bleeding during coronary artery bypass for patients under treatment of low molecular weight heparin
Koroner arter bypass operasyonlarında düşük molekül ağırlıklı heparin tedavisi gören hastalarda traneksamik asidin kanama üzerine etkileri

Mevlüt DOĞUKAN [1] , Fahriye GÜLER [2] , Ayşe BAYSAL [3] , Cengiz GÜVEN [4] , Öznur ULUDAG [5]


Aim: Tranexamic acid (TA) is an antifibrinolytic agent that prevents the dissolution of fibrin clot. We investigated the impact of the use of tranexamic acid (TA) on bleeding for patients under treatment of low molecular weight heparin during coronary artery bypass graft (CABG) operations.
Methods: Among 82 patients, 60 patients undergoing CABG with cardiopulmonary bypass (CPB) were enrolled into a case-control study within a six month-period. On the first postoperative day, patients were divided into two groups depending on the intraoperative use of TA. TA was not administered to control group patients (n=30) while those in the study group (n=30) received TA intravenously at a dose of 10 mg/kg. Coagulation variables including complete blood cell count, D-Dimer, fibrinogen, prothrombin time (PT), activated partial thromboplastin time (aPTT) and international normalized ratio (INR) values were collected preoperatively and 24 hours after surgery. Estimated blood loss, loss by drainage, total amounts of packed red blood cell and fresh frozen plasma transfusions were recorded. P-value <0.05 was considered statistically significant.
Results: Among 60 patients included in the study, there were 39 and 21 males and females, respectively. The mean age of all patients was 61.6 years. The two groups were similar in terms of use of fresh frozen plasma, age, height, and weight (P=0.268, P=0.586, P=0.787, P=0.641, respectively). The amount of postoperatively transfused packed red blood cells in units were lower in the study group (P=0.04). Total mediastinal drainage amounts in the 4th, 8th, 12th hours and overall were lower in the study group (P=0.016, P=0.006, P=0.013, P=0.04, respectively).
Conclusions: TA is a safe drug that reduces postoperative bleeding without side effects in patients using DMAH undergoing CABG operations.

Amaç: Traneksamik asit (TA), fibrin pıhtısının çözünmesini önleyen antifibrinolitik bir maddedir. Koroner arter bypass greft (KABG) operasyonları sırasında düşük moleküler ağırlıklı heparin tedavisi alan hastalarda TA kullanımının kanama üzerindeki etkisini araştırdık.
Yöntemler: Toplam 82 hastadan, kardiyopulmoner bypass (CPB) ile KABG uygulanan 60 hasta, altı aylık bir dönemde vaka-kontrol bir çalışmaya alındı. Ameliyat sonrası birinci günde, intraoperatif TA kullanımına bağlı olarak hastalar iki gruba ayrıldı. Kontrol grubunda (n=30) TA verilmezken, çalışma grubunda Grup 2'de (n=30) TA intravenöz 10 mg/kg dozda uygulandı. Pıhtılaşma değişkenleri; tam kan hücresi sayımı, D-Dimer, fibrinojen, protrombin zamanı (PT), aktive parsiyel tromboplastin zamanı (aPTT) ve uluslararası normalleştirilmiş oran (INR) değerleri ameliyat öncesi ve ameliyattan 24 saat sonra toplandı. Tahmini kan kaybı, drenaj kaybı, toplam eritrosit süspansiyonu ve taze donmuş plazma hacimleri kaydedildi. P-değeri <0.05 istatistiksel olarak anlamlı kabul edildi.
Bulgular: Çalışmaya alınan, 60 hastanın 39’si erkek, 21’i kadın, hastaların yaş ortalaması 61,6/ yıl idi. Hastaların yaş, boy, kilo verileri benzerdi (sırası ile; P=0,586, P=0,787, P=0,641). Postoperatif verilen taze donmuş plazna transfüzyonu iki grupta benzer iken (P=0,692), postoperatif verilen eritrosit süspansiyonu ünite miktarı çalışma grubunda daha düşüktü (P=0,04). Ameliyat sonrası, 4., 8., 12. ve total mediastinal drenaj miktarları çalışma grubunda daha düşüktü (sırasıyla; P=0,016, P=0,006, P=0,013, P=0,04).
Sonuç: TA, CABG operasyonları sırasında DMAH tedavisi alan hastalarda yan etki olmaksızın postoperatif kanamayı azaltan güvenli bir ilaçtır. 

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Birincil Dil en
Konular Anestezi
Bölüm Araştırma makalesi
Yazarlar

Orcid: 0000-0002-4890-758X
Yazar: Mevlüt DOĞUKAN (Sorumlu Yazar)
Kurum: ADIYAMAN ÜNİVERSİTESİ
Ülke: Turkey


Orcid: 0000-0001-5481-9474
Yazar: Fahriye GÜLER
Kurum: İSTANBUL KARTAL KOŞUYOLU YÜKSEK İHTİSAS EĞİTİM VE ARAŞTIRMA HASTANESİ
Ülke: Turkey


Orcid: 0000-0002-1487-7404
Yazar: Ayşe BAYSAL
Kurum: SAĞLIK BİLİMLERİ ÜNİVERSİTESİ, İSTANBUL KARTAL KOŞUYOLU YÜKSEK İHTİSAS SAĞLIK UYGULAMA VE ARAŞTIRMA MERKEZİ
Ülke: Turkey


Orcid: 0000-0001-9693-434X
Yazar: Cengiz GÜVEN
Kurum: ADIYAMAN ÜNİVERSİTESİ, TIP FAKÜLTESİ
Ülke: Turkey


Orcid: 0000-0002-6017-5836
Yazar: Öznur ULUDAG
Kurum: ADIYAMAN ÜNİVERSİTESİ, TIP FAKÜLTESİ
Ülke: Turkey


Tarihler

Yayımlanma Tarihi : 1 Nisan 2020

Bibtex @araştırma makalesi { josam713471, journal = {Journal of Surgery and Medicine}, issn = {}, eissn = {2602-2079}, address = {jsurgmed@gmail.com}, publisher = {Fatih BAŞAK}, year = {2020}, volume = {4}, pages = {309 - 313}, doi = {10.28982/josam.713471}, title = {Impact of tranexamic acid on bleeding during coronary artery bypass for patients under treatment of low molecular weight heparin}, key = {cite}, author = {Doğukan, Mevlüt and Güler, Fahriye and Baysal, Ayşe and Güven, Cengiz and Uludag, Öznur} }
APA Doğukan, M , Güler, F , Baysal, A , Güven, C , Uludag, Ö . (2020). Impact of tranexamic acid on bleeding during coronary artery bypass for patients under treatment of low molecular weight heparin . Journal of Surgery and Medicine , 4 (4) , 309-313 . DOI: 10.28982/josam.713471
MLA Doğukan, M , Güler, F , Baysal, A , Güven, C , Uludag, Ö . "Impact of tranexamic acid on bleeding during coronary artery bypass for patients under treatment of low molecular weight heparin" . Journal of Surgery and Medicine 4 (2020 ): 309-313 <https://jsurgmed.com/tr/pub/issue/53710/713471>
Chicago Doğukan, M , Güler, F , Baysal, A , Güven, C , Uludag, Ö . "Impact of tranexamic acid on bleeding during coronary artery bypass for patients under treatment of low molecular weight heparin". Journal of Surgery and Medicine 4 (2020 ): 309-313
RIS TY - JOUR T1 - Impact of tranexamic acid on bleeding during coronary artery bypass for patients under treatment of low molecular weight heparin AU - Mevlüt Doğukan , Fahriye Güler , Ayşe Baysal , Cengiz Güven , Öznur Uludag Y1 - 2020 PY - 2020 N1 - doi: 10.28982/josam.713471 DO - 10.28982/josam.713471 T2 - Journal of Surgery and Medicine JF - Journal JO - JOR SP - 309 EP - 313 VL - 4 IS - 4 SN - -2602-2079 M3 - doi: 10.28982/josam.713471 UR - https://doi.org/10.28982/josam.713471 Y2 - 2020 ER -
EndNote %0 Journal of Surgery and Medicine Impact of tranexamic acid on bleeding during coronary artery bypass for patients under treatment of low molecular weight heparin %A Mevlüt Doğukan , Fahriye Güler , Ayşe Baysal , Cengiz Güven , Öznur Uludag %T Impact of tranexamic acid on bleeding during coronary artery bypass for patients under treatment of low molecular weight heparin %D 2020 %J Journal of Surgery and Medicine %P -2602-2079 %V 4 %N 4 %R doi: 10.28982/josam.713471 %U 10.28982/josam.713471
ISNAD Doğukan, Mevlüt , Güler, Fahriye , Baysal, Ayşe , Güven, Cengiz , Uludag, Öznur . "Impact of tranexamic acid on bleeding during coronary artery bypass for patients under treatment of low molecular weight heparin". Journal of Surgery and Medicine 4 / 4 (Nisan 2020): 309-313 . https://doi.org/10.28982/josam.713471
AMA Doğukan M , Güler F , Baysal A , Güven C , Uludag Ö . Impact of tranexamic acid on bleeding during coronary artery bypass for patients under treatment of low molecular weight heparin. J Surg Med. 2020; 4(4): 309-313.
Vancouver Doğukan M , Güler F , Baysal A , Güven C , Uludag Ö . Impact of tranexamic acid on bleeding during coronary artery bypass for patients under treatment of low molecular weight heparin. Journal of Surgery and Medicine. 2020; 4(4): 309-313.
IEEE M. Doğukan , F. Güler , A. Baysal , C. Güven ve Ö. Uludag , "Impact of tranexamic acid on bleeding during coronary artery bypass for patients under treatment of low molecular weight heparin", Journal of Surgery and Medicine, c. 4, sayı. 4, ss. 309-313, Nis. 2020, doi:10.28982/josam.713471