RESUMEN

INTRODUÇÃO: O ácido épsilon aminocapróico é um antifibrinolítico usado em cirurgia cardiovascular a fim de inibir a fibrinólise e reduzir o sangramento após circulação extracorpórea (CEC). OBJETIVO: Analisar a influência do uso do ácido aminocapróico no sangramento e na necessidade de hemotransfusão nas primeiras 24 horas em pós-operatório de cirurgias valvares mitrais. MÉTODOS: Estudo prospectivo, 42 pacientes, randomizados e divididos em dois grupos, de igual número: grupo I - controle e grupo II - ácido épsilon aminocapróico. No grupo II, foram infundidos 5 gramas de AEAC na indução anestésica, após heparinização plena, no perfusato da CEC, após reversão da heparina e uma hora após o final da cirurgia, totalizando 25 gramas. No grupo I, foi infundido apenas soro fisiológico nestes mesmos momentos. RESULTADOS: O grupo I apresentou volume de sangramento médio de 633,57 ± 305,7 ml e o grupo II média de 308,81 ± 210,1 ml, com diferença estatisticamente significativa (P=0,0003). O volume médio de hemotransfusão nos grupos I e II foi, respectivamente, de 942,86 ± 345,79 ml e de 214,29 ± 330,58 ml, havendo diferença significativa (P<0,0001). CONCLUSÃO: O ácido épsilon aminocapróico foi capaz de reduzir o volume de sangramento e a necessidade de hemoderivados no pós-operatório imediato de pacientes submetidos a cirurgias valvares mitrais.

INTRODUCTION: The epsilon aminocaproic acid is an antifibrinolytic used in cardiovascular surgery to inhibit the fibrinolysis and to reduce the bleeding after CBP. OBJECTIVE: To analyze the influence of the using of epsilon aminocaproic acid in the bleeding and in red-cell transfusion requirement in the first twenty-four hours postoperative of mitral valve surgery. METHODS: Prospective studying, forty-two patients, randomized and divided in two equal groups: group #1 control and group #2 - epsilon aminocaproic acid. In Group II were infused five grams of EACA in the induction of anesthesia, after full heparinization, CPB perfusate after reversal of heparin and one hour after the surgery, totaling 25 grams. In group I, saline solution was infused only in those moments. RESULTS: Group #1 showed average bleeding volume of 633.57 ± 305,7 ml, and Group #2, an average of 308.81 ± 210.1 ml, with significant statistic difference (P=0.0003). Average volume of red-cell transfusion requirement in Groups 1 and 2 was, respectively, 942.86 ± 345.79 ml and 214.29 ± 330.58 ml, with significant difference (P<0.0001). CONCLUSION: The epsilon aminocaproic acid was able to reduce the bleeding volume and the red-cell transfusion requirement in the immediate postoperative of patients submitted to mitral valve surgery.

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RESUMEN

INTRODUCTION: The epsilon aminocaproic acid is an antifibrinolytic used in cardiovascular surgery to inhibit the fibrinolysis and to reduce the bleeding after CPB. [corrected] OBJECTIVE: To analyze the influence of the using of epsilon aminocaproic acid in the bleeding and in red-cell transfusion requirement in the first twenty-four hours postoperative of mitral valve surgery. METHODS: Prospective studying, forty-two patients, randomized and divided in two equal groups: group #1 control and group #2--epsilon aminocaproic acid. In Group II were infused five grams of EACA in the induction of anesthesia, after full heparinization, CPB perfusate after reversal of heparin and one hour after the surgery, totaling 25 grams. In group I, saline solution was infused only in those moments. RESULTS: Group #1 showed average bleeding volume of 633.57 ± 305,7 ml, and Group #2, an average of 308.81 ± 210.1 ml, with significant statistic difference (P = 0.0003). Average volume of red-cell transfusion requirement in Groups 1 and 2 was, respectively, 942.86 ± 345.79 ml and 214.29 ± 330.58 ml, with significant difference (P < 0.0001). CONCLUSION: The epsilon aminocaproic acid was able to reduce the bleeding volume and the red-cell transfusion requirement in the immediate postoperative of patients submitted to mitral valve surgery.

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