COMPARISON OF TOPICAL USE OF PROTAMINE AND TRANEXAMIC ACID IN SURGICAL PATIENTS REQUIRING CARDIO-PULMONARY BYPASS

Protamine and Tranexamic Acid in Cardio-Pulmonary Bypass

Abstract

Objective: To determine the effectiveness of local protamine in reducing post-operative blood loss compared to local tranexamic acid.

Study Design: Randomized controlled trial.

Place and Duration of Study: Armed Forces Institute of Cardiology/National Institute of Heart Diseases Rawalpindi from January 2011 to September 2011.

Patients and Methods: One hundred and twenty cardiac surgical patients were randomly divided into two equal groups, one receiving local protamine while the other group receiving local tranexamic acid before chest closure. The efficiency was measured as post-operative blood loss and requirement of blood and blood products in the post-surgical ICU.

Results: Average blood loss in protamine group was significantly less (252.97 ml) compared to tranexamic acid group (680.67 ml). Number of patients requiring no post-operative blood transfusion was significantly higher in protamine group (76.7%) compared to tranexamic acid group (53.3%).

Conclusion:  Local protamine is more effective in reducing post-operative blood loss than local tranexamic acid.