EFFECT OF APROTININ, TRANEXAMIC ACID VERSUS EPSILON AMINOCAPROIC ACID ON CHANGES IN COAGULATION PATTERNS, BLOOD LOSS AND BLOOD USE AFTER CARDIOPULMONARY BYPASS IN NON CYANOTIC PEDIATRIC PATIENTS

Abstract

Contact of the patient's blood and cells with the non­ endothelial surface of the extracorporporeal circuit is responsible for several reactions due to disturbance of the hemostatic system with activation of the plasma proteolytic system. However anticoagulation with heparin doesn't block the early phases of contact activation.

Antifibrinolytic drugs have been used either to treat or to prevent excessive bleeding associated with cardiac surgery. Aprotinin, a natural antifibrinolytic prevents plasmin degradation of platelet function and inhibits thrombin generation. Epsilon aminocaproic acid and Tranexamic acid are synthetic antifibrinolytic bind to lysine binding site of plasminogen and prevent binding to fibrin and hence fibrinolysis.

The effect of these drugs on blood loss, homologous blood transfusion and coagulation patterns in pediatric non-cyanotic cardiac patients, undergoing open-heart surgery was investigated. In the present study 80 patients were studied, patients were divided into four groups, 20 patients received aprotinin, 20 patients received Epsilon aminocaproic acid, 20 patients received Tranexamic acid and 2o patients received no drug.