Influência do ácido épsilon aminocapróico no sangramento e na hemotransfusão pós-operatória em cirurgia valvar mitral

Abstract

Introduction: The epsilon-aminocaproic acid is an antifibrinolytic used in cardiovascular surgery to inhibit the fibrinolysis and to reduce the bleeding after CBP. Objective: To assess the influence of the use of epsilonaminocaproic acid in the bleeding and in red-cell transfusion requirement in the first twenty-four hours of postoperative of mitral valve surgery. Methods: Prospective study, forty-two patients, randomized and divided into two equal groups: group #1 - control and group #2 - epsilon-aminocaproic acid. In Group II were infused five grams of EACA in the induction of anesthesia, after full heparinization, CPB perfusate after reversal of heparin and one hour after surgery, totaling 25 grams. In group I, saline solution was infused only in those moments. Results: Group #1 showed average bleeding volume of 633.57 ± 305,7 ml, and Group #2, an average of 308.81 ± 210.1 ml, with s ignif icant stat i st ic di fference (P=0.0003). Average volume of red-cell transfusion requirement in Groups 1 and 2 was, respectively, 942.86 ± 345.79 ml and 214.29 ± 330.58 ml, with significant difference (P<0.0001). Conclusion: The epsilon-aminocaproic acid was able to reduce the bleeding volume and the red-cell transfusion requirement in the immediate postoperative of patients who underwent mitral valve surgery.