Comparison of blood-sparing efficacy of ∈-aminocaproic acid and tranexamic acid in newborns undergoing cardiac surgery

Background: ∈-Aminocaproic acid (EACA) and tranexamic acid (TXA) are used for antifibrinolytic therapy in neonates undergoing cardiac surgery, although data directly comparing their blood-sparing efficacy are not yet available. We compared two consecutive cohorts of neonates for the effect of these two medications on perioperative blood loss and allogeneic transfusions. Material and Methods: Data from the EACA group (n=77) were collected over a 12-month period; data from the tranexamic acid group (n=28) were collected over a 5-month period. Blood loss, rate of reoperation due to bleeding, and transfusion requirements were measured. Results: There was no significant difference in blood loss at 6 hours (EACA 24 [1730] mL/kg [median (interquartile range)] vs. TXA 20 [1134] mL/kg, p=0.491), at 12 hours (EACA 31 [2238] mL/kg vs. TXA 27 [1943] ml/kg, p=0.496) or at 24 hours postoperatively (EACA 41 [3147] mL/kg vs. TXA 39 [2760] mL/kg; p=0.625) or transfusion of blood products. Conclusions: -Aminocaproic acid and tranexamic acid are equally effective with respect to perioperative blood loss and transfusion requirements in newborns undergoing cardiac surgery.