Evaluation of Epsilon Amino-Caproic Acid (EACA) and Autologous Blood as Blood Conservation Strategies in Patients Undergoing Cardiac Surgery

Background

To evaluate the effects of autologous blood and Epsilon amino-caproic acid on intra-operative and post-operative blood loss and homologous blood product requirements in patients undergoing cardiac surgery.

Methods

Patients were randomly allocated to two groups of 30 each. In the Epsilon amino-caproic acid (EACA) group, the drug was administered in a loading dose of 100mg/kg before skin incision followed by an infusion of 1/5th the loading dose hourly and terminated 3h after heparin neutralization. In the autologous transfusion (AT) group, 10% of the calculated whole blood volume was collected intra-operatively before cardiopulmonary bypass and re-infused after its termination.

Results

Haemoglobin values were comparable pre-operatively, on cardiopulmonary bypass, off cardiopulmonary bypass and post-operatively on day two in both groups. Intra-operative blood loss was not significantly different (643.3±129.14ml in group EACA versus 710±145.5ml in group AT, p=0.66). Although the chest drainage was more in group AT during 0–3h (71.3±54.3ml versus 112.6±79.3.6ml, p=0.006) it was comparable amongst in the first 24h (231.1±98.3ml in group AT versus 235±101.4ml in group EACA, p=0.88). Homologous blood product requirements were similar in both groups.

Conclusion

Autologous blood is as efficacious as Epsilon amino-caproic acid for blood conservation in cardiac surgery.

Keywords: Blood conservation, Autologous blood, Epsilon amino-caproic acid