• Marta Kelava, Anand Mehta, Shiva Sale, Marc Gillinov, Douglas Johnston, Lucy Thuita, Nikhil Kumar, and Eugene H Blackstone.
• Department of Cardiothoracic Anesthesiology, Anesthesiology Institute, Cleveland Clinic Foundation, Cleveland, OH. Electronic address: kelavam@ccf.org.
• J. Cardiothorac. Vasc. Anesth. 2022 Oct 1; 36 (10): 3780-3790.

ObjectivesTo examine E-aminocaproic acid effectiveness in reducing transfusion requirements in overall and less-invasive cardiac surgery, and to assess its safety.DesignRetrospective cohort study.SettingSingle-center tertiary academic medical center.ParticipantsA total of 19,111 adult patients who underwent elective surgery requiring cardiopulmonary bypass from January 1, 2008, through December 31, 2016.InterventionsNone.Measurements And Main ResultsPropensity matching was used to create well-balanced groups and separately compare both overall cohort and less-invasive surgery with and without E-aminocaproic acid. Supplementary zero-inflated negative binomial regression analysis was used because outcome data were zero-inflated. Effectiveness was assessed by transfusion requirements, and safety by comparison of in-hospital outcomes. In the overall cohort, patients receiving E-aminocaproic acid received fewer red blood cells postoperatively and fewer intra- and postoperativel blood products. In a less-invasive cohort, there was no significant difference in red blood cell transfusion either intra- or postoperatively, but the E-aminocaproic group received fewer intra- and postoperative platelets, intraoperative cryoprecipitate, and postoperative plasma. There were no significant differences for in-hospital outcomes in both less-invasive and overall cohorts.ConclusionsThe reduction of postoperative red blood cell requirement observed when analyzing the overall cohort did not translate to less-invasive cardiac surgery in the authors' patient population; however, both overall and less-invasive cohorts had lower requirements for other blood components with E-aminocaproic acid. There was no association with major Society of thoracic surgeons (STS)-defined morbidity and mortality in both groups.Copyright © 2022 Elsevier Inc. All rights reserved.

14 keywords...

hide…