AUTHOR=Zhang Yu , Zhang Xue , Wang Yang , Shi Jia , Yuan Su , Duan Fujian , Wang Yuefu , Zhang Zhe , Jia Yuan , Gong Junsong , Li Lihuan , Yan Fuxia 

TITLE=Efficacy and Safety of Tranexamic Acid in Pediatric Patients Undergoing Cardiac Surgery: A Single-Center Experience

JOURNAL=Frontiers in Pediatrics

VOLUME=7

YEAR=2019

URL=https://www.frontiersin.org/journals/pediatrics/articles/10.3389/fped.2019.00181

DOI=10.3389/fped.2019.00181

ISSN=2296-2360

ABSTRACT=<p><bold>Aims:</bold> This study evaluated the efficacy and safety of tranexamic acid (TXA) undergoing cardiac surgery.</p><p><bold>Methods:</bold> Using a retrospective cohort study design, 2,026 consecutive pediatric patients who underwent surgical repair of atrial or ventricular septal defect or complete repair of Tetralogy of Fallot were included, and divided into a control group and a TXA group.</p><p><bold>Results:</bold> Compared with that in the control group, there were statistically significant reduction of both the 12-h and total postoperative blood loss in the TXA group [6.573 ± 0.144 vs. 5.499 ± 0.133 ml kg<sup>−1</sup>, mean difference (MD) 1.074 ml kg<sup>−1</sup>, <italic>p</italic> &lt; 0.001; 12.183 ± 0.298 vs. 9.973 ± 0.276 ml kg<sup>−1</sup>, MD, 2.210 ml kg<sup>−1</sup>, <italic>p</italic> &lt; 0.001]. There was a statistically significant reduction of the MD of 12-h postoperative blood loss due to TXA in patients aged &lt; 1 year compared with that in patients aged ≥1 year (MD, 1.544 vs. 0.681 ml kg-1, <italic>P</italic> = 0.007). There were statistically significant reduction of the MD of both the 12-h and total postoperative blood loss due to TXA in patients weighing &lt; 10 kg compared with that in patients weighing ≥10 kg (MD, 1.542 vs. 0.456 ml kg-1, <italic>P</italic> &lt; 0.001, and MD, 2.195 vs. 0.929 ml kg-1, <italic>P</italic> = 0.036, respectively). There was a statistically significant reduction of the MD of total postoperative blood loss due to TXA in cyanotic patients compared with that in acyanotic patients (MD, 3.381 vs. 1.038 ml kg<sup>−1</sup>, <italic>P</italic> = 0.002). There was no significant difference in the postoperative volume or exposure of allogeneic transfusion, in-hospital morbidity or mortality between the groups.</p><p><bold>Conclusions:</bold> TXA took effects in reduction of postoperative blood loss but not the allogeneic transfusion requirement in pediatric patients undergoing cardiac surgery, particularly in infants weighing &lt; 10 kg and cyanotic children. Moreover, the study suggested the use of TXA was safe in pediatric cardiac surgery.</p>