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Dosage of Epsilon-Aminocaproic Acid to Reduce Postoperative Blood Loss

Department of Cardiothoracic and Vascular Surgery Cardiothoracic Sciences Centre All India Institute of Medical Sciences New Delhi, India

For reprint information contact: Akshay Kumar Bisoi, MCh Tel: 91 11 686 4851 Fax: 91 11 686 2663 Department of Cardiothoracic and Vascular Surgery, Cardiothoracic Sciences Centre, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India.

Postoperative blood loss, blood and blood-product requirements, and complications were compared for 3 commonly used doses of epsilon-aminocaproic acid in 150 patients undergoing first-time coronary artery bypass surgery. The patients were randomly assigned to one of 4 groups. Group 1 (n = 30) served as a control, group 2 (n = 30) received a single dose of 150 mg•kg^–1 of epsilon-aminocaproic acid after anesthetic induction, group 3 (n = 30) received a loading dose of 150 mg•kg^–1 followed by infusion of 1 g•h^–1 for 6 hours, and group 4 (n = 60) received doses of 150 mg•kg^–1 at induction, on bypass, and after protamine. No patients, including those who had endarterectomies, experienced any complications attributable to epsilon-aminocaproic acid administration. All patients who received epsilon-aminocaproic acid had significantly less bleeding compared to controls. Groups 3 and 4 had the least blood loss and packed-cell requirements.