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Long Duration of Action of Tranexamic Acid After Cardiac Surgery in a Hemodialysis Patient: A Case Report

Long Duration of Action of Tranexamic Acid After Cardiac Surgery in a Hemodialysis Patient: A... A 61-year-old woman with chronic renal dysfunction was scheduled to undergo aortic valve replacement. After a bolus of 1 g tranexamic acid (TXA), the TPA (tissue-plasminogen activator)-test result with the ClotPro system demonstrated extensive inhibition of fibrinolysis. Plasma TXA level decreased from 71 to 25 μg/dL at 6 hours postoperatively; however, no further decrease was observed. Although TXA levels dropped to 6.9 μg/dL after hemodialysis on postoperative day (PoD) 1, fibrinolytic shutdown on the TPA-test remained unchanged until PoD 2. In dialysis patients, low-dose TXA <1 g may be considered for reducing seizure and thromboembolic complications after cardiac surgery. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png A & A Case Reports Wolters Kluwer Health

Long Duration of Action of Tranexamic Acid After Cardiac Surgery in a Hemodialysis Patient: A Case Report

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Publisher
Wolters Kluwer Health
Copyright
Copyright © 2023 International Anesthesia Research Society.
ISSN
2325-7237
eISSN
2575-3126
DOI
10.1213/xaa.0000000000001676
Publisher site
See Article on Publisher Site

Abstract

A 61-year-old woman with chronic renal dysfunction was scheduled to undergo aortic valve replacement. After a bolus of 1 g tranexamic acid (TXA), the TPA (tissue-plasminogen activator)-test result with the ClotPro system demonstrated extensive inhibition of fibrinolysis. Plasma TXA level decreased from 71 to 25 μg/dL at 6 hours postoperatively; however, no further decrease was observed. Although TXA levels dropped to 6.9 μg/dL after hemodialysis on postoperative day (PoD) 1, fibrinolytic shutdown on the TPA-test remained unchanged until PoD 2. In dialysis patients, low-dose TXA <1 g may be considered for reducing seizure and thromboembolic complications after cardiac surgery.

Journal

A & A Case Reports – Wolters Kluwer Health

Published: May 5, 2023

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