Comparative effectiveness of epsilon-aminocaproic acid and tranexamic acid on postoperative bleeding following cardiac surgery during a national medication shortage JOURNAL OF CLINICAL ANESTHESIA Blaine, K. P., Press, C., Lau, K., Sliwa, J., Rao, V. K., Hill, C. 2016; 35: 516-523

Abstract

The aim of this study was to compare the effectiveness of epsilon-aminocaproic acid (eACA) and tranexamic acid (TXA) in contemporary clinical practice during a national medication shortage.A retrospective cohort study.The study was performed in all consecutive cardiac surgery patients (n=128) admitted to the cardiac-surgical intensive care unit after surgery at a single academic center immediately before and during a national medication shortage.Demographic, clinical, and outcomes data were compared by descriptive statistics using ?(2) and t test. Surgical drainage and transfusions were compared by multivariate linear regression for patients receiving eACA before the shortage and TXA during the shortage.In multivariate analysis, no statistical difference was found for surgical drain output (OR 1.10, CI 0.97-1.26, P=.460) or red blood cell transfusion requirement (OR 1.79, CI 0.79-2.73, P=.176). Patients receiving eACA were more likely to receive rescue hemostatic medications (OR 1.62, CI 1.02-2.55, P=.041).Substitution of eACA with TXA during a national medication shortage produced equivalent postoperative bleeding and red cell transfusions, although patients receiving eACA were more likely to require supplemental hemostatic agents.

View details for DOI 10.1016/j.jclinane.2016.08.037

View details for Web of Science ID 000389785600092

View details for PubMedID 27871586