The effect of Premarin on blood loss attending open heart surgery

Abstract

Premarin was administered prophylactically to every other patient in a series of 148 consecutive cases of open intracardiac surgery. Of these, 132 patients were matched to analyse the results of Premarin administration and postoperative blood loss. There were 67 patients who were given Premarin and 65 who did not receive this drug; both groups were identical in respect of age and sex. Matching was undertaken according to history of previous cardiac operations and anticoagulation, type of valve surgery or repair of congenital anomaly, duration of perfusion, platelet count and the use of fresh blood and epsilon-aminocaproic acid in the postoperative period. The prophylactic use of Premarin was not associated with a reduction in postoperative bleeding.

A Practical Concept for Preoperative Management of Patients With Impaired Primary Hemostasis

“…Aprotinin (17,18), tranexamic acid, εaminocaproic acid (19,20), and premarin (a mixture of conjugated estrogens) (21) are less commonly used in these indications. However, there still is no validated concept of when to use these drugs or how to assess their effects before or during a surgical intervention.…”

“…Tranexamic acid was effective in 12 of 16, aprotinin in 3 of 5, and factor VIII concentrates with vWF in all 4 pa-of vasopressin (8)(9)(10)(11)(12)(13)(14)(15)(16), has been shown to reduce blood loss and the need for blood transfusion in selected groups of surgical patients at an increased risk of bleeding due to platelet dysfunction. Aprotinin (17,18), tranexamic acid, εaminocaproic acid (19,20), and premarin (a mixture of conjugated estrogens) (21) are less commonly used in these indications. However, there still is no validated concept of when to use these drugs or how to assess their effects before or during a surgical intervention.…”