Reduction of bleeding after heart operations through the prophylactic use of epsilon-aminocaproic acid

Salm, Thomas J. Vander; Kaur, Shubjeet; Lancey, Robert; Okike, Okike N.; Pezzella, A. Thomas; Stahl, Russell F.; Leone, Lisa; Li, Jianming; Valeri, C. R.; Michelson, Alan D.

doi:10.1016/s0022-5223(96)70112-5

Cited by 110 publications

(31 citation statements)

References 39 publications

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“…Indications and therapeutic effects of EACA were widely presented and discussed in literature (21)(22)(23)(24)(25), mainly as an evaluation of a decrease of postoperative bleedings and a decrease of a volume of lost blood. Therapeutic effects of EACA and aprotinine are comparable (26)(27)(28)(29)(30)(31)(32).…”

Section: Therapeutic Indications Pharmacokinecitsmentioning

confidence: 99%

ε-Aminocaproic Acid (EACA)

Gacko

Worowska

2008

Polish Journal of Surgery

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Section: Therapeutic Indications Pharmacokinecitsmentioning

confidence: 99%

ε-Aminocaproic Acid (EACA)

Gacko

Worowska

2008

Polish Journal of Surgery

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“…[13][14][15][16] It has a very low complication rate. It was thought that this would have efficacy in pediatric spine surgery.…”

mentioning

confidence: 99%

The Role of Amicar in Decreasing Perioperative Blood Loss in Idiopathic Scoliosis

Thompson

Florentino-Pineda

Poe-Kochert

2005

Spine

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“…When clopidogrel has not been stopped before surgery (for example, emergency procedure), the use of antifibrinolytics (aprotinin, epsilon-aminocaproic acid or tranexamic acid) could be proposed, since such treatments decrease postoperative blood loss and transfusion requirements, without increasing early graft closure. [69][70][71][72][73][74][75][76][77] More recently, it was emphasized that ASA or clopidogrel resistance was common after CABG, suggesting the possible need for adjusted dosage or alternative therapy in such patients. [78][79][80] The combination of ASA with dipyridamole or vitamin K antagonists is not recommended for the prevention of postoperative graft thrombosis.…”

Section: Antiplatelet Therapy In the Prevention Of Graft Occlusion Anmentioning

confidence: 99%

Antithrombotic therapy in cardiac surgery

Vincentelli

Jude

Bélisle

2006

Can J Anesth/J Can Anesth

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Purpose: To review the perioperative management of antithrombotic therapy in cardiac surgery, including the management of cardiopulmonary bypass (CPB) and off-pump surgery.Methods: A review of the relevant English literature over the period was undertaken, in addition to a review of international practices in antithrombotic therapy in cardiac surgery. Principal findings:Cardiopulmonary bypass is required in most procedures and makes anticoagulation mandatory. Anticoagulation is, usually, achieved with unfractionnated heparin (UFH). Unfractionated heparin is monitored by point-ofcare (POC) testing, such as the activated clotting time or the determination of heparin concentration. The target values of both tests remain empirical, with no clearly validated thresholds. The target value needs to be adjusted according to the POC test, given significant variations between devices and activators. After CABG, the need for antiplatelet therapy is well demonstrated, in order to limit the risk of postoperative death or ischemic events, and improve venous graft patency. Immediately after valvular surgery, antithrombotic therapy should take into account the specific risk carried by each patient and by each prosthetic device. The risk of venous thromboembolism, though poorly defined, is also present in the postoperative period and may require additional attention. Given the frequent exposure to UFH, occurrence of heparininduced thrombocytopenia is not infrequent in these patients and requires careful individual management. Conclusions:Antithrombotic therapy is an essential component of cardiac surgery. Yet, with the exception of antiplatelet agents in CABG patients, antithrombotic therapy is often based on the clinical experience of medical teams more than on an evidence-based assessment of the literature. Objectif Constatations principales : La circulation extracorporelle est nécessaire pour la majorité des opérations et rend l'anticoagulation obligatoire. L'anticoagulation est, habituellement, réalisée avec de l'héparine non fractionnée (HNF). L'HNF est contrôlée par des tests faits au chevet du malade comme le temps de coagulation activée ou la détermination de la concentration d'héparine. Les valeurs cible des deux tests demeurent empiriques, sans valeurs seuil clairement validées. La valeur cible doit être ajustée en fonction de chaque test de chevet à cause des variations significatives entre les instruments et les activateurs. Après le pontage aortocoronarien (PAC), la nécessité d'un traitement antiplaquettaire a été bien démontrée, qui vise à limiter les décès postopératoires ou les incidents ischémiques et à améliorer la

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Reduction of bleeding after heart operations through the prophylactic use of epsilon-aminocaproic acid

Abstract: The intraoperative use of epsilon-aminocaproic acid reduces postoperative cardiac surgical bleeding.

Cited by 110 publications

References 39 publications

ε-Aminocaproic Acid (EACA)

ε-Aminocaproic Acid (EACA)

The Role of Amicar in Decreasing Perioperative Blood Loss in Idiopathic Scoliosis

Antithrombotic therapy in cardiac surgery

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