Drugs to Minimize Perioperative Blood Loss in Cardiac Surgery

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Abstract
P aprotmm was associated with a sig- n&ant decrease in the need for reoperation because of bleeding (OR 0.44,95% CI 0.27-0.73; P = 0.001). Desmo- ressin was not effective, with an OR of 0.98 (95% CI 0.64- Y = .50; P 0.92). Tranexamic acid significantly decreased the proportion of patients transfused (OR 0.50, 95% CI 0.34-0.76; P = 0.0009). .+Aminocaproic acid did not have e statisticalk sir 'ficant effect on the proportion of a- bents trans se (OR 0.20, 95% CI 0.04-1.12; P = 0. t 7). There were not enough patients to exclude a small but clinically im other side ef P ortant increase in myocardial infarction or ects for any of the medications. We conclude that aprotinin and tranexamic acid, but not desmopressin, decrease the number of patients exposed to perio erative allogeneic transfusions in association with car % lac sur- ge tIcp' Im lications: Aprotinin, desmo ressin, tranexamic acl , an l -ammocaproic acid are use g. m cardiac surgery in an attempt to decrease the proportion of patients re- quiring blood transfusion. This meta-analysis of all pub- lished randomized trials provides a good estimate of the efficacy of these medications and is useful in ical practice. We conclude that aprotinin an ti"