Observational studyJournal of cardiothoracic surgery2026
Triple-dose bolus versus continuous infusion of tranexamic acid: impacts on clinical outcomes in isolated coronary artery bypass surgery.
Observational study in Journal of cardiothoracic surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05994989 (The Effect of Two Different Tranexamic Acid Dose Regimens on Intraoperative and Postoperative Bleeding in Coronary Artery Bypass Surgery), which is not on this map. Not yet cited in PubMed.
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The Effect of Two Different Tranexamic Acid Dose Regimens on Intraoperative and Postoperative Bleeding in Coronary Artery Bypass Surgery
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Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundIn cardiac surgery, intraoperative tranexamic acid (TXA) is commonly used and highly recommended approach for managing perioperative bleeding. Nevertheless, a standardized dose and administration protocol remains undefined. This study compares the efficacy of intraoperative triple-dose intravenous (IV) bolus TXA versus IV bolus followed by continuous IV infusion in preventing postoperative bleeding in patients undergoing isolated coronary artery bypass grafting (CABG).
methodsThe study included 93 patients who underwent elective isolated CABG between August 14, 2023, and October 14, 2024. Patients received either triple-dose IV bolus TXA (Group 1, n = 53) or IV bolus followed by continuous IV infusion (Group 2, n = 40) during surgery.
resultsPostoperative bleeding was lower in Group 1 at all assessed time points (1 h: 116 vs. 146 mL; 6 h: 253 vs. 332 mL; 24 h: 589 vs. 713 mL). However, a statistically significant difference was found only at 6 h (p = 0.03), representing an approximately 24% relative reduction in bleeding volume compared with Group 2. No significant differences were observed in transfusion requirements (packed red blood cells p = 0.85; fresh frozen plasma p = 0.55). Three patients in Group 2 required reoperation due to bleeding (p = 0.07), and one late mortality occurred in Group 2 (p = 0.43).
conclusionThis study suggests that triple-dose IV bolus TXA administration may be both an effective and safe strategy for preventing postoperative bleeding in isolated CABG surgery.
trial registrationThe study was registered at the Clinical Trial Registry (NCT05994989, August 8, 2023) on.
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