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. 2019 Oct 22;9(5):e96096.
doi: 10.5812/aapm.96096. eCollection 2019 Oct.

Comparison Effect of Tranexamic Acid (TA) and Tranexamic Acid Combined with Vitamin C (TXC) on Drainage Volume and Atrial Fibrillation Arrhythmia in Patients Undergoing Cardiac Bypass Surgery: Randomized Clinical Trial

Koorosh Ghorbaninezhad  1 , Fozieh Bakhsha  2 , Zahra Yousefi  2 , Solmaz Halakou  2 , Zahra Mehrbakhsh  3
Affiliations

Comparison Effect of Tranexamic Acid (TA) and Tranexamic Acid Combined with Vitamin C (TXC) on Drainage Volume and Atrial Fibrillation Arrhythmia in Patients Undergoing Cardiac Bypass Surgery: Randomized Clinical Trial

Koorosh Ghorbaninezhad et al. Anesth Pain Med. .

Abstract

Background: Tranexamic acid and vitamin C are potent antifibrinolytic and oxidative stress agents that reduce blood loss and transfusion blood in cardiopulmonary bypass (CPB).

Objectives: The aim of this study was to evaluate the efficacy of tranexamic acid (TA) and tranexamic acid combined with vitamin C (TXC) on drainage volume (blood loss) and atrial fibrillation (AF) in patients undergoing cardiac bypass surgery in Gorgan, Shafa hospital, Iran.

Methods: This study is a double-blind randomized clinical trial. A sample size of 120 candidates of cardiac bypass surgery were included in this prospective study. Patients were randomly assigned to treatments in two groups. In both groups, 50 mg/kg tranexamic acid was administered intravenously directly before sternotomy: group A (N = 58) patients received tranexamic acid (TA) only and group B (N = 62) tranexamic acid with vitamin C (TXC) half an hour before surgery and 2 g vitamin C with 100 mL 0.9% saline were injected. Subsequently, during 4 days after surgery, 1000 mg of vitamin C and 100 cc 0.9% saline was infused every day. Intraoperative and postoperative blood loss (volume of blood in the drain) and atrial fibrillation complications were recorded for 24 hours after the operation.

Results: The patients who received vitamin C had less bleeding during operation and in the early hours post-operation. Patients in (TA) group had mean drainage of 34.41 milliliter more than patients in (TXC) group (P < 0.001). Chi-square test showed that arrhythmia (AF) condition was the same in the two groups during 14 times of study (four times during operation and ten times up to 24 hours after the operation), and AF arrhythmia in the two groups was less than 5%.

Conclusions: In this study tranexamic acid with vitamin C have a positive effect on the amount of drainage (blood loss) and there was no significant difference in the incidence of AF between two groups.

Keywords: Atrial Fibrillation; Blood Loss; Hemodynamic Changes; Tranexamic Acid; Vitamin C.

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Conflict of interest statement

Conflict of Interests: There is no conflict of interests regarding this study.

Figures

Figure 1.
Figure 1.. The consort flow chart describing the progress of subjects through the study
Figure 2.
Figure 2.. Mean drainage volume difference between in two groups (TA) and (TXC) at each time in during surgery
Figure 3.
Figure 3.. Mean drainage volume difference between two groups of (TA) and (TXC) at each time post-surgery
See this image and copyright information in PMC

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