Influência do ácido épsilon aminocapróico no sangramento e na hemotransfusão pós-operatória em cirurgia valvar mitral

Benfatti, Ricardo Adala; Carli, Amanda Ferreira; Silva, Guilherme Viotto Rodrigues da; Dias, Amaury Edgardo Mont'Serrat Ávila Souza; Goldiano, José Anderson; Pontes, José Carlos Dorsa Vieira

doi:10.1590/s0102-76382010000400015

Cited by 8 publications

(5 citation statements)

References 19 publications

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“…Souza & Braile [ 24 ] demonstrated that a hemoconcentration during the CPB associated to a reduced water balance, is also able to decrease the use of blood and plasma in cardiac surgery. Other interventions consist in the use of antifibrinolytic agents, such as epsilon-aminocaproic acid [ 25 ] , making routine use of normovolemic hemodilution and total replacement of perfusate [ 26 ] . A study performed in patients undergoing CABG surgery without CPB, reported low rates of postoperative complications, less blood products transfusion, and lower mortality [ 27 ] .…”

Section: Discussionmentioning

confidence: 99%

Mortality risk is dose-dependent on the number of packed red blood cell transfused after coronary artery bypass graft

Santos¹,

Sousa²,

Piotto³

et al. 2013

Revista Brasileira De Cirurgia Cardiovascular

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IntroductionTransfusions of one or more packed red blood cells is a widely strategy used in cardiac surgery, even after several evidences of increased morbidity and mortality. The world's blood shortage is also already evident. ObjectiveTo assess whether the risk of mortality is dose-de>pendent on the number of packed red blood cells transfused after coronary artery bypass graft. MethodsBetween June 2009 and July 2010, were analyzed 3010 patients: transfused and non-transfused. Transfused patients were divided into six groups according to the number of packed red blood cells received: one, two, three, four, five, six or more units, then we assess the mortality risk in each group after a year of coronary artery bypass graft. To calculate the odds ratio was used the multivariate logistic regression model. ResultsThe increasing number of allogeneic packed red blood cells transfused results in an increasing risk of mortality, highlighting a dose-dependent relation. The odds ratio values increase with the increased number of packed red blood cells transfused. The death's gross odds ratio was 1.42 (P=0.165), 1.94 (P=0.005), 4.17; 4.22, 8.70, 33.33 (P<0.001) and the adjusted death's odds ratio was 1.22 (P=0.43), 1.52 (P=0.08); 2.85; 2.86; 4.91 and 17.61 (P<0.001), as they received one, two, three, four, five, six or more packed red blood cells, respectively. ConclusionThe mortality risk is directly proportional to the number of packed red blood cells transfused in coronary artery bypass graft. The greater the amount of allogeneic blood transfused the greater the risk of mortality. The current transfusion practice needs to be reevaluated.

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Section: Discussionmentioning

confidence: 99%

Mortality risk is dose-dependent on the number of packed red blood cell transfused after coronary artery bypass graft

Santos¹,

Sousa²,

Piotto³

et al. 2013

Revista Brasileira De Cirurgia Cardiovascular

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“…Lins et al12 studied aims to evaluate the surgical treatment of atrial fibrillation with ultrasound ablation concomitant to mitral surgery in patients with permanent atrial fibrillation and claim that patients who received treatment for atrial fibrillation simultaneously with valvar surgery had advantages related to the control group. Benfatti et al13 analyzed the influence of using of epsilon aminocaproic acid in the bleeding and in red-cell transfusion requirement in the first twenty-four hours postoperative of mitral valve surgery. They conclude that the epsilon aminocaproic acid was able to reduce the bleeding volume and the red-cell transfusion requirement in the immediate postoperative of patients submitted to mitral valve surgery.…”

Section: Introductionmentioning

confidence: 99%

A survey of recently published cardiovascular, hematological and pneumological original articles in the Brazilian scientific press

Patel¹,

Caramelli²,

Gomes³

2011

Clinics

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Recent original scientific contributions published in selected Brazilian periodicals and classifiable under cardiovascular and pulmonary subject categories cover a wide range of sub specialties, both clinical and exprimental. Because they appear in journals with only recently enhanced visibility, we have decided to highlight a number of specific items appeared in four Brazilian journals, because we understand that this is an important subsidy to keep our readership adequately informed. These papers cover extensive sub-areas in both fields.

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“…Other proposed measures are the use of antifibrinolytic agent, aminocaproic acid [26], minimum use of CPB, especially in relation to its duration [27]. Others relevant care include preoperative patient meticulous assessment, implementation of intraoperative and postoperative measures for reducing blood loss and transfusion, active involvement of the surgeon, physician, anesthesiologist and intensivist, and as well as the use of algorithms for patients assessment and treatment, can significantly reduce transfusion need and prove to be lifesaving in cases of serious bleeding.…”

Section: Discussionmentioning

confidence: 99%

Impact on early and late mortality after blood transfusion in coronary artery bypass graft surgery

Santos¹,

Sousa²,

Thomé³

et al. 2013

Revista Brasileira De Cirurgia Cardiovascular

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Influência do ácido épsilon aminocapróico no sangramento e na hemotransfusão pós-operatória em cirurgia valvar mitral

Cited by 8 publications

References 19 publications

Mortality risk is dose-dependent on the number of packed red blood cell transfused after coronary artery bypass graft

Mortality risk is dose-dependent on the number of packed red blood cell transfused after coronary artery bypass graft

A survey of recently published cardiovascular, hematological and pneumological original articles in the Brazilian scientific press

Impact on early and late mortality after blood transfusion in coronary artery bypass graft surgery

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