کد مقاله کد نشریه سال انتشار مقاله انگلیسی نسخه تمام متن
8937591 1644633 2009 11 صفحه PDF دانلود رایگان
عنوان انگلیسی مقاله ISI
Antifibrinolytics in cardiac surgical patients receiving aspirin: a systematic review and meta-analysis
موضوعات مرتبط
علوم پزشکی و سلامت پزشکی و دندانپزشکی بیهوشی و پزشکی درد
پیش نمایش صفحه اول مقاله
Antifibrinolytics in cardiac surgical patients receiving aspirin: a systematic review and meta-analysis
چکیده انگلیسی
While conventional practice is to discontinue aspirin prior to elective cardiac surgery there is evidence that its continuation may be associated with improved perioperative outcomes. However, uncertainty exists regarding the efficacy of antifibrinolytic agents in the presence of aspirin. We performed a systematic review and meta-analysis of the literature to address the question of the effects of antifibrinolytic agents in cardiac surgery patients maintained on aspirin in terms of both efficacy and adverse events. We conducted an extensive search for randomized controlled trials of antifibrinolytic use in adult patients undergoing coronary artery bypass grafting ± valve surgery, where aspirin therapy was maintained or initiated through the preoperative period. Data from 17 trials (n=1620) confirmed the efficacy of antifibrinolytic therapy to reduce both chest-tube drainage (weighted mean difference 374 ml, 95% CI 275-473 ml; P<0.00001) and blood transfusion requirements (odds ratio 0.37, 95% CI 0.27-0.49; P<0.00001) in cardiac surgical patients receiving aspirin. We found no difference in the rates of adverse events between groups but observed a trend towards a reduced risk for the composite outcome of thrombotic complications (odds ratio 0.49, 95% CI 0.21-1.13; P=0.09). Antifibrinolytic agents are effective for reducing both chest-tube drainage and transfusion requirements in cardiac surgical patients receiving aspirin. We found no difference between antifibrinolytic and placebo in terms of adverse events but the population was predominantly low-risk. Further studies are required to determine the optimal balance between antiplatelet and antifibrinolytic effects in cardiac surgery.
ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: British Journal of Anaesthesia - Volume 102, Issue 2, February 2009, Pages 168-178
نویسندگان
, , , ,