• Kevin P Blaine, Christopher Press, Ken Lau, Jan Sliwa, Vidya K Rao, and Charles Hill.
• Department of Anesthesia, Pain, and Perioperative Medicine, Stanford University Medical Center, 300 Pasteur Dr, H3580, Stanford, CA 97305. Electronic address: kevin.blaine@nih.gov.
• J Clin Anesth. 2016 Dec 1; 35: 516-523.

Study ObjectiveThe aim of this study was to compare the effectiveness of epsilon-aminocaproic acid (εACA) and tranexamic acid (TXA) in contemporary clinical practice during a national medication shortage.DesignA retrospective cohort study.SettingThe study was performed in all consecutive cardiac surgery patients (n=128) admitted to the cardiac-surgical intensive care unit after surgery at a single academic center immediately before and during a national medication shortage.MeasurementsDemographic, clinical, and outcomes data were compared by descriptive statistics using χ(2) and t test. Surgical drainage and transfusions were compared by multivariate linear regression for patients receiving εACA before the shortage and TXA during the shortage.Main ResultsIn multivariate analysis, no statistical difference was found for surgical drain output (OR 1.10, CI 0.97-1.26, P=.460) or red blood cell transfusion requirement (OR 1.79, CI 0.79-2.73, P=.176). Patients receiving εACA were more likely to receive rescue hemostatic medications (OR 1.62, CI 1.02-2.55, P=.041).ConclusionsSubstitution of εACA with TXA during a national medication shortage produced equivalent postoperative bleeding and red cell transfusions, although patients receiving εACA were more likely to require supplemental hemostatic agents.Published by Elsevier Inc.

23 keywords...

hide…