Comparison of Blood-Sparing Efficacy of ε-Aminocaproic Acid and Tranexamic Acid in Newborns Undergoing Cardiac Surgery

Abstract

Background: ε-Aminocaproic acid (EACA) and tranexamic acid (TXA) are used for antifibrinolytic therapy in neonates undergoing cardiac surgery, although data directly comparing their blood-sparing efficacy are not yet available. We compared two consecutive cohorts of neonates for the effect of these two medications on perioperative blood loss and allogeneic transfusions. Material and Methods: Data from the EACA group (n = 77) were collected over a 12-month period; data from the tranexamic acid group (n = 28) were collected over a 5-month period. Blood loss, rate of reoperation due to bleeding, and transfusion requirements were measured. Results: There was no significant difference in blood loss at 6 hours (EACA 24 [17–30] mL/kg [median (interquartile range)] vs. TXA 20 [11–34] mL/kg, p = 0.491), at 12 hours (EACA 31 [22–38] mL/kg vs. TXA 27 [19–43] ml/kg, p = 0.496) or at 24 hours postoperatively (EACA 41 [31–47] mL/kg vs. TXA 39 [27–60] mL/kg; p = 0.625) or transfusion of blood products. Conclusions: ε-Aminocaproic acid and tranexamic acid are equally effective with respect to perioperative blood loss and transfusion requirements in newborns undergoing cardiac surgery.

blood transfusion (includes blood typing) - congenital heart disease - CHD - neonate - cardiopulmonary bypass - CPB

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