Celite-activated viscometer Sonoclot can measure the suppressive effect of tranexamic acid on hyperfibrinolysis in cardiac surgery | Sonoclot Analyzer India | Life Diagnostica

Celite-activated viscometer Sonoclot can measure the suppressive effect of tranexamic acid on hyperfibrinolysis in cardiac surgery

Abstract Purpose. To investigate the usefulness of the celiteactivated viscometer Sonoclot for monitoring fibrinolytic status in cardiac surgery, we demonstrated the effectiveness of high doses of tranexamic acid, an antifibrinolytic agent, in reducing postoperative bleeding. Methods. Thirty-two American Society of Anesthesiologists (ASA) physical status III patients who required cardiac surgery with cardiopulmonary bypass (CPB) were studied. Anesthesia was induced by a high dose of fentanyl and midazolam with oxygen and was maintained by the intermittent administration of these agents.

Patients were divided into two groups: the control group (n = 15) and patients receiving tranexamic acid (TA; n = 17). The TA group received a high dose (50 mg/kg) of TA twice, once before and once after CPB. The percentage diminishing rate of the Sonoclot tracing 15 min after maximum clot signal (DR15) and the amount of postoperative bleeding were measured.

Results. After CPB, DR15 in the control group (mean 28.3%) increased significantly by 45%, and the DR15 in the TA group (16.1%) was significantly lower than that in the control group. The amount of postoperative bleeding in the TA group (546 ml) was significantly less, by 34%, than that in the control group (829 ml).

Conclusion. Prophylactic administration of high-dose TA in cardiac surgery reduces postoperative bleeding, and this effect is consistent with changes in the diminishing rate using Sonoclot. The eliteactivated viscometer Sonoclot Analyzer is recommended for use in cardiac surgery for rapid assessment of fibrinolytic status.

Yasuhiro Kamada1, Michiaki Yamakage1, Tomohisa Niiya1, Naoki Tsujiguchi1, Xiangdong Chen1 and Akiyoshi Namiki1

(1) Department of Anesthesiology, Sapporo Medical University, School of Medicine, South 1, West 16, Chuo-ku, Sapporo, Hokkaido 060-8543, Japan, JP

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