caa a22 4500 445373377 CHVBK 20180317142954.0 cr unu---uuuuu 170323e20111201xx s 000 0 eng 10.1007/s00540-011-1235-z doi (NATIONALLICENCE)springer-10.1007/s00540-011-1235-z Effect of tranexamic acid on blood loss in pediatric cardiac surgery: a randomized trial [Elektronische Daten] [Kazuyoshi Shimizu, Yuichiro Toda, Tatsuo Iwasaki, Mamoru Takeuchi, Hiroshi Morimatsu, Moritoki Egi, Tomohiko Suemori, Satoshi Suzuki, Kiyoshi Morita, Shunji Sano] Purpose: The benefit of tranexamic acid (TXA) in pediatric cardiac surgery on postoperative bleeding has varied among studies. It is also unclear whether the effects of TXA differ between cyanotic patients and acyanotic patients. The aim of this study was to test the benefit of TXA in pediatric cardiac surgery in a well-balanced study population of cyanotic and acyanotic patients. Methods: A total of 160 pediatric patients undergoing cardiac surgery with cardiopulmonary bypass (81 cyanotic, 79 acyanotic) were included in this single-blinded, randomized trial at a tertiary care university-affiliated teaching hospital. Eighty-one children (41 cyanotic, 40 acyanotic) were randomly assigned to a TXA group, in which they received 50mg/kg of TXA as a bolus followed by 15mg/kg/h infusion and another 50mg/kg into the bypass circuit. The other 79 patients were randomly assigned to a placebo group. The primary end point was the amount of 24-h blood loss. Results: The amount of 24-h blood loss was significantly less in the TXA group than in the placebo group [mean (95% confidence interval): 18.6 (15.8-21.4) vs. 23.5 (19.4-27.5) ml/kg, respectively; mean difference −4.9 (−9.7 to −0.01) ml/kg; p=0.049]. This effect of TXA was already significant at 6h [9.5 (7.5-11.5) vs. 13.2 (10.6-15.9) ml/kg, respectively; mean difference −3.47 (−7.0 to −0.4) ml/kg; p=0.027]. However, there was no significant difference in the amount of blood transfusion between the groups. There was also no statistical difference in the effect of TXA in each cyanotic and acyanotic subgroup. Conclusion: TXA can reduce blood loss in pediatric cardiac surgery but not the transfusion requirement ( http://ClinicalTrials.gov number NCT00994994). Japanese Society of Anesthesiologists, 2011 Tranexamic acid nationallicence Children nationallicence Cardiac surgery nationallicence Blood loss nationallicence Cyanosis nationallicence Shimizu Kazuyoshi Department of Anesthesiology and Resuscitology, Okayama University Hospital, 2-5-1 Shikata-cho, 700-8558, Kita-ku, Okayama, Okayama, Japan aut Toda Yuichiro Department of Anesthesiology and Resuscitology, Okayama University Hospital, 2-5-1 Shikata-cho, 700-8558, Kita-ku, Okayama, Okayama, Japan aut Iwasaki Tatsuo Department of Anesthesiology and Resuscitology, Okayama University Hospital, 2-5-1 Shikata-cho, 700-8558, Kita-ku, Okayama, Okayama, Japan aut Takeuchi Mamoru Pediatric Operating Suite and Intensive Care, Jichi Children's Medical Center Tochigi, Jichi Medical University, 3311-1 Yakushiji, 329-0498, Shimono, Tochigi, Japan aut Morimatsu Hiroshi Department of Anesthesiology and Resuscitology, Okayama University Hospital, 2-5-1 Shikata-cho, 700-8558, Kita-ku, Okayama, Okayama, Japan aut Egi Moritoki Department of Anesthesiology and Resuscitology, Okayama University Hospital, 2-5-1 Shikata-cho, 700-8558, Kita-ku, Okayama, Okayama, Japan aut Suemori Tomohiko Department of Anesthesiology and Resuscitology, Okayama University Hospital, 2-5-1 Shikata-cho, 700-8558, Kita-ku, Okayama, Okayama, Japan aut Suzuki Satoshi Department of Anesthesiology and Resuscitology, Okayama University Hospital, 2-5-1 Shikata-cho, 700-8558, Kita-ku, Okayama, Okayama, Japan aut Morita Kiyoshi Department of Anesthesiology and Resuscitology, Okayama University Hospital, 2-5-1 Shikata-cho, 700-8558, Kita-ku, Okayama, Okayama, Japan aut Sano Shunji Department of Cardiovascular Surgery, Okayama University Hospital, 2-5-1 Shikata-cho, 700-8558, Kita-ku, Okayama, Okayama, Japan aut Journal of Anesthesia Springer Japan 25/6(2011-12-01), 823-830 0913-8668 25:6<823 2011 25 540 https://doi.org/10.1007/s00540-011-1235-z text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s00540-011-1235-z text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Shimizu Kazuyoshi Department of Anesthesiology and Resuscitology, Okayama University Hospital, 2-5-1 Shikata-cho, 700-8558, Kita-ku, Okayama, Okayama, Japan aut NATIONALLICENCE 700 1- Toda Yuichiro Department of Anesthesiology and Resuscitology, Okayama University Hospital, 2-5-1 Shikata-cho, 700-8558, Kita-ku, Okayama, Okayama, Japan aut NATIONALLICENCE 700 1- Iwasaki Tatsuo Department of Anesthesiology and Resuscitology, Okayama University Hospital, 2-5-1 Shikata-cho, 700-8558, Kita-ku, Okayama, Okayama, Japan aut NATIONALLICENCE 700 1- Takeuchi Mamoru Pediatric Operating Suite and Intensive Care, Jichi Children's Medical Center Tochigi, Jichi Medical University, 3311-1 Yakushiji, 329-0498, Shimono, Tochigi, Japan aut NATIONALLICENCE 700 1- Morimatsu Hiroshi Department of Anesthesiology and Resuscitology, Okayama University Hospital, 2-5-1 Shikata-cho, 700-8558, Kita-ku, Okayama, Okayama, Japan aut NATIONALLICENCE 700 1- Egi Moritoki Department of Anesthesiology and Resuscitology, Okayama University Hospital, 2-5-1 Shikata-cho, 700-8558, Kita-ku, Okayama, Okayama, Japan aut NATIONALLICENCE 700 1- Suemori Tomohiko Department of Anesthesiology and Resuscitology, Okayama University Hospital, 2-5-1 Shikata-cho, 700-8558, Kita-ku, Okayama, Okayama, Japan aut NATIONALLICENCE 700 1- Suzuki Satoshi Department of Anesthesiology and Resuscitology, Okayama University Hospital, 2-5-1 Shikata-cho, 700-8558, Kita-ku, Okayama, Okayama, Japan aut NATIONALLICENCE 700 1- Morita Kiyoshi Department of Anesthesiology and Resuscitology, Okayama University Hospital, 2-5-1 Shikata-cho, 700-8558, Kita-ku, Okayama, Okayama, Japan aut NATIONALLICENCE 700 1- Sano Shunji Department of Cardiovascular Surgery, Okayama University Hospital, 2-5-1 Shikata-cho, 700-8558, Kita-ku, Okayama, Okayama, Japan aut NATIONALLICENCE 773 0- Journal of Anesthesia Springer Japan 25/6(2011-12-01), 823-830 0913-8668 25:6<823 2011 25 540 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer