5. Combination Of Oral Versus Intravenous Formulation Of Tranexamic Acid And Ethamsylate In Controlling Postoperative Bleeding Of Cardiac Surgeries Done Under CPB

B. Sartaj Hussain, Madhavi Gaddam, G. Srinivas

ABSTRACT

Background and Objective: The aim of the study is to evaluate efficacy of Tranexamic acid and Ethamsylate in oral and intravenous forms in 'reduction of post cardiopulmonary bypass bleeding' in patients undergoing mitral valve replacement surgery. Methods: All patients with rheumatic heart valvular disease are enrolled serially and decided to study up to 100 consecutive patients that meets inclusion criteria. Patients are randomly divided into 2 groups, 'oral' and 'intravenous', containing 50 patients in each group using card method. Results: Bleeding time, Clotting time, Activated clotting time and Platelet count are the observed parameters in both the groups in the pre bypass, post bypass and postoperative period for 24 hrs. The respective values are statistically analyzed to compare the efficacy of oral and intravenous drug combination of Ethamsylate and Tranexamic acid in mitral valve replacement surgeries. Blood collected in the mediastinal and pleural drains is measured to assess the postoperative bleeding for next 24 hrs and quantified to compare with oral and intravenous formulations. Conclusion: A Combination of Ethamsylate and Tranexamic acid are quite effective both in the parenteral and oral forms in reducing post CPB and post operative bleeding in valve replacement surgeries for rheumatic heart disease. The oral form when started 24 hours prior to surgery is as effective as intravenous formulation.

Key-words: Activated clotting time (ACT), Cardiopulmonary bypass (CPB), Ethamsylate, mitral valve replacement surgery, Tranexamic acid.

[Full Text Article]