Tags

Type your tag names separated by a space and hit enter

Tranexamic acid does not correct the haemostatic impairment caused by hydroxyethyl starch (200 kDa/0.5) after cardiac surgery.
Blood Coagul Fibrinolysis. 2006 Nov; 17(8):639-45.BC

Abstract

We investigated the effect of intravenous tranexamic acid on hydroxyethyl starch (HES)-induced clot strength impairment after cardiac surgery. Patients were randomized to receive either 1 g tranexamic acid or the same volume of 0.9% saline after administration of 15 ml/kg of 6% HES (molecular weight, 200 kDa; degree of substitution, 0.5) in the immediate postoperative period. Modified thromboelastometry (ROTEM) using different activators [intrinsic ROTEM (InTEM), extrinsic ROTEM (ExTEM), fibrinogen ROTEM (FibTEM)] was carried out to evaluate clot formation and lysis. The clot formation time was prolonged, and the maximum clot firmness (MCF) and shear elastic modulus [G = 5000 x MCF / (100-MCF), dynes/cm(2)] decreased (all activators of ROTEM) after completion of HES (P < 0.001, two-factor analysis of variance). These abnormalities in blood coagulation persisted despite tranexamic acid. Maximal lysis (FibTEM), indicative of fibrinolytic activity, was increased after HES but no effect of tranexamic acid was observed. The cumulative chest tube drainage until the first postoperative morning was not different between the groups (1008 +/- 251 and 1081 +/- 654 ml, P = 0.698, respectively). We conclude that after cardiopulmonary bypass, HES-induced impairment in clot formation and strength, or increased fibrinolytic capacity, is not reversed by the administration of tranexamic acid.

Authors+Show Affiliations

Department of Anaesthesiology and Intensive Care Medicine, Helsinki University Hospital, Meilahti Hospital, Helsinki, Finland.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

17102650

Citation

Kuitunen, Anne H., et al. "Tranexamic Acid Does Not Correct the Haemostatic Impairment Caused By Hydroxyethyl Starch (200 kDa/0.5) After Cardiac Surgery." Blood Coagulation & Fibrinolysis : an International Journal in Haemostasis and Thrombosis, vol. 17, no. 8, 2006, pp. 639-45.
Kuitunen AH, Suojaranta-Ylinen RT, Kukkonen SI, et al. Tranexamic acid does not correct the haemostatic impairment caused by hydroxyethyl starch (200 kDa/0.5) after cardiac surgery. Blood Coagul Fibrinolysis. 2006;17(8):639-45.
Kuitunen, A. H., Suojaranta-Ylinen, R. T., Kukkonen, S. I., & Niemi, T. T. (2006). Tranexamic acid does not correct the haemostatic impairment caused by hydroxyethyl starch (200 kDa/0.5) after cardiac surgery. Blood Coagulation & Fibrinolysis : an International Journal in Haemostasis and Thrombosis, 17(8), 639-45.
Kuitunen AH, et al. Tranexamic Acid Does Not Correct the Haemostatic Impairment Caused By Hydroxyethyl Starch (200 kDa/0.5) After Cardiac Surgery. Blood Coagul Fibrinolysis. 2006;17(8):639-45. PubMed PMID: 17102650.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Tranexamic acid does not correct the haemostatic impairment caused by hydroxyethyl starch (200 kDa/0.5) after cardiac surgery. AU - Kuitunen,Anne H, AU - Suojaranta-Ylinen,Raili T, AU - Kukkonen,Sinikka I, AU - Niemi,Tomi T, PY - 2006/11/15/pubmed PY - 2007/2/16/medline PY - 2006/11/15/entrez SP - 639 EP - 45 JF - Blood coagulation & fibrinolysis : an international journal in haemostasis and thrombosis JO - Blood Coagul Fibrinolysis VL - 17 IS - 8 N2 - We investigated the effect of intravenous tranexamic acid on hydroxyethyl starch (HES)-induced clot strength impairment after cardiac surgery. Patients were randomized to receive either 1 g tranexamic acid or the same volume of 0.9% saline after administration of 15 ml/kg of 6% HES (molecular weight, 200 kDa; degree of substitution, 0.5) in the immediate postoperative period. Modified thromboelastometry (ROTEM) using different activators [intrinsic ROTEM (InTEM), extrinsic ROTEM (ExTEM), fibrinogen ROTEM (FibTEM)] was carried out to evaluate clot formation and lysis. The clot formation time was prolonged, and the maximum clot firmness (MCF) and shear elastic modulus [G = 5000 x MCF / (100-MCF), dynes/cm(2)] decreased (all activators of ROTEM) after completion of HES (P < 0.001, two-factor analysis of variance). These abnormalities in blood coagulation persisted despite tranexamic acid. Maximal lysis (FibTEM), indicative of fibrinolytic activity, was increased after HES but no effect of tranexamic acid was observed. The cumulative chest tube drainage until the first postoperative morning was not different between the groups (1008 +/- 251 and 1081 +/- 654 ml, P = 0.698, respectively). We conclude that after cardiopulmonary bypass, HES-induced impairment in clot formation and strength, or increased fibrinolytic capacity, is not reversed by the administration of tranexamic acid. SN - 0957-5235 UR - https://www.unboundmedicine.com/medline/citation/17102650/Tranexamic_acid_does_not_correct_the_haemostatic_impairment_caused_by_hydroxyethyl_starch__200_kDa/0_5__after_cardiac_surgery_ L2 - https://doi.org/10.1097/01.mbc.0000252598.25024.68 DB - PRIME DP - Unbound Medicine ER -