CHANGES IN COAGULATION PATTERNS, BLOOD-LOSS AND BLOOD USE AFTER CARDIOPULMONARY BYPASS - APROTININ VS TRANEXAMIC ACID VS EPSILON-AMINOCAPROIC ACID

Cardiopulmonary bypass (CPB) increases risk of postoperative bleeding and need for transfusion, The aim of this study was to evaluate the ef fects of aprotinin, epsilon aminocaproic acid and tranexamic acid on c oagulation patterns and need for banked blood transfusion. Ninety-six consecutive patients who underwent coronary artery bypass surgery were randomly assigned to 4 groups (24 patients each). The following param etrs were monitored before, during and after CPB: activated letting ti me, hemoglobin, prothrombin time, activated prothromboplastin time, fi brinogen, antithrombin III, xDP, Factor VIII, Thrombin-Antithrombin Co mplex and plasminogen, Analysis of postoperative bleeding and need for transfusion showed that the aprotinin group had significantly lower m ediastinal bleeding, Transfused patients were 2, 4, 12 and 18 respecti vely in the aprotinin, epsilon aminocaproic acid, tranexamic acid and placebo treated group, In conclusion the use of protease inhibitors si gnificantly reduces postoperative bleeding and transfusion, The aproti nin-treated group had the lower need for transfusion.