Antifibrinolytic drugs reduce blood loss during cardiac surgery

Oct 17, 2007

The amount of blood loss that occurs during major complex surgery is limited by the body’s ability to form blood clots. These close off small vessels and prevent more blood leaking out of the patient’s circulatory system. One problem is that the body also has mechanisms that break down blood clots.

This Cochrane Review concludes that drugs that slow down the rate at which these blood clots are dissolved, called anti-fibrinolytics, can significantly reduce blood loss, particularly during cardiac surgery, and reduce the need for re-operation because of continued bleeding. One of the effective drugs, tranexamic acid, is quite cheap and is likely to be cost effective, particularly in cardiac surgery.

The big question is whether the benefits of treatment with these drugs are offset by adverse effects, in particular thrombosis leading to an excess risk of heart attack and stroke. This has been a particular concern with aprotinin and some studies that did not use randomisation found an increased risk of these complications with this drug. However, this Cochrane Review of randomised controlled trials found no increase in the risk of thrombosis with aprotinin or tranexamic acid.

“Our review of over 200 clinical trials found that using anti-fibrinolytic drugs during surgery reduced bleeding and reduced the need for transfusions of red blood cells. Importantly they did not appear to increase the risk of serious adverse effects,” says lead researcher Professor David Henry, of the University of Newcastle, Waratah, Australia.

“This is an extremely important finding,” says Professor Mike Clarke, the UK Cochrane Centre Director. “It shows very strongly that anti-fibrinolytics, which are cheap, can dramatically reduce the need for blood transfusion. Blood is scarce, expensive and transfusions can be dangerous, so this is likely to be a very important finding globally.”

Source: John Wiley & Sons, Inc.

Explore further: Pentagon: Anthrax shipments broader than first thought

Related Stories

A turning point in the physics of blood

May 07, 2015

Mike Graham knows that fluid dynamics can reveal much about how the flow of blood helps and hinders individual blood cells as they go about their work.

Recommended for you

Pentagon: Anthrax shipments broader than first thought

1 hour ago

The Pentagon said Friday that the Army's mistaken shipments of live anthrax to research laboratories were more widespread than it initially reported, prompting the Defense Department's second-ranking official ...

Anthrax shipments came from military site in Utah desert

16 hours ago

The U.S. Army's mistaken shipment of live anthrax samples to government and commercial laboratories occurred at a military post in a desolate stretch of the Utah desert that has been testing chemical weapons ...

User comments : 0

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.