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Case Reports
Long Duration of Action of Tranexamic Acid After Cardiac Surgery in a Hemodialysis Patient: A Case Report.
- Ryogo Yoshii, Yuya Takahashi, Teiji Sawa, Fumimasa Amaya, and Satoru Ogawa.
- From the Department of Anesthesiology, Kyoto Prefectural University of Medicine, Kyoto, Japan.
- A A Pract. 2023 May 1; 17 (5): e01676e01676.
AbstractA 61-year-old woman with chronic renal dysfunction was scheduled to undergo aortic valve replacement. After a bolus of 1 g tranexamic acid (TXA), the TPA (tissue-plasminogen activator)-test result with the ClotPro system demonstrated extensive inhibition of fibrinolysis. Plasma TXA level decreased from 71 to 25 μg/dL at 6 hours postoperatively; however, no further decrease was observed. Although TXA levels dropped to 6.9 μg/dL after hemodialysis on postoperative day (PoD) 1, fibrinolytic shutdown on the TPA-test remained unchanged until PoD 2. In dialysis patients, low-dose TXA <1 g may be considered for reducing seizure and thromboembolic complications after cardiac surgery.Copyright © 2023 International Anesthesia Research Society.
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