The recent article by Sharma and colleagues discusses the relative merits of epsilon amino-caproic acid (EACA) (Amicar) and autologous blood donation using intra-operative normovolaemic haemodilution. They used Pentastarch as the replacement fluid.
1It should be noted that EACA is not universally available around the world. It has been withdrawn from sale from many countries including Australia and Europe. It is not licensed for use as a prophylactic treatment in cardiac surgery. Henry et al., in a Cochrane review of antifibrinolytic therapy showed the low rate of adverse events associated with EACA
- Sharma V.
- Talwar S.
- Choudhary S.K.
- Lakshmy R.
- Kale S.
- Kumar A.S.
Evaluation of epsilon amino-caproic acid (EACA) and autologous blood as blood conservation strategies in patients undergoing cardiac surgery.
Heart Lung Circ. 2006; 15: 261-265
2but there have been no studies designed and powered to detect low rate events with EACA in cardiac surgery.
- Henry D.A.
- Moxey A.J.
- Carless P.A.
- O’Connell D.
- McClelland B.
- Henderson K.M.
- Sly K.
- Laupacis A.
- Fergusson D.
Anti-fibrinolytic use for minimising perioperative allogeneic blood transfusion.
Cochrane Database Syst Rev. 2001; : CD001886
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- Evaluation of epsilon amino-caproic acid (EACA) and autologous blood as blood conservation strategies in patients undergoing cardiac surgery.Heart Lung Circ. 2006; 15: 261-265
- Anti-fibrinolytic use for minimising perioperative allogeneic blood transfusion.Cochrane Database Syst Rev. 2001; : CD001886
- Effect of peri-operative red blood cell transfusion on 30-day and 1-year mortality following coronary artery bypass surgery.Eur J Cardiothorac Surg. 2005; 27: 592-598
- Transfusion in coronary artery bypass grafting is associated with reduced long-term survival.Ann Thorac Surg. 2006; 81: 1650-1657
Received: September 17, 2006
© 2006 Australasian Society of Cardiac and Thoracic Surgeons and the Cardiac Society of Australia and New Zealand. Published by Elsevier Inc. All rights reserved.