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The use of antifibrinolytic agents such as to reduce blood loss in congenital cardiac surgery has been described in many studies
40 patients in each one of the three groups; In control group will receive normal saline, Intravenous Tranexamic acid group received 50 mg / kg intravenousely followed by of 1 mg/kg/hr.for six hours. The topical Tranexamic acid group will have 50 mg / kg of tranexamic poured into the pericoredial cavity. in the first 24 hours we will measure the total blood loss and transfusion requirements. Complate blood picture and coagulation studies will be recorded. the occurrence of re-exploration for excess bleeding, or adverse events.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Group 1 | Placebo Comparator | In control group will receive normal saline, |
|
| Group 2 | Active Comparator | Intravenous Tranexamic acid group will received Intravenous 50 mg / kg followed by infusion of 1 mg/kg/hr for six hours |
|
| Group 3 | Active Comparator | the topical Tranexamic acid group will receive 50 mg / kg poured before sternal closure. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Normal saline at induction | Drug | 0.5 ml/kg |
| |
| Measure | Description | Time Frame |
|---|---|---|
| postoperative blood loss | Blood loss will be measured within first 24 hr. | within the first 24 hours |
| Measure | Description | Time Frame |
|---|---|---|
| total blood transfusion | ml/kg | within the first 24 hours |
| the interval from protamine to skin closure | the interval from protamine to skin closure |
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Inclusion Criteria:
2 to 12 years cyanotic cardiac disease with cardio pulmonary bypass
Exclusion Criteria:
Previous cardiac surgery any operation within 48 hr., previous inotropes or mechanical vention aprotinin exposure Liver or renal impairment Coagulation or hemostatic dysfunction within the last 7 days before surgery.
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| Name | Affiliation | Role |
|---|---|---|
| Sayed k Abd-Elshafy, MD | Associate profossor of anesthesiology | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Faculty of Medicine | Asyut | 74111 | Egypt |
UNDECIDED
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| ID | Term |
|---|---|
| D019106 | Postoperative Hemorrhage |
| ID | Term |
|---|---|
| D006470 | Hemorrhage |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D011183 | Postoperative Complications |
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| ID | Term |
|---|---|
| D014148 | Tranexamic Acid |
| D000077330 | Saline Solution |
| ID | Term |
|---|---|
| D003509 | Cyclohexanecarboxylic Acids |
| D000146 | Acids, Carbocyclic |
| D002264 | Carboxylic Acids |
| D009930 | Organic Chemicals |
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| Normal saline infusion |
| Drug |
1ml/kg/hr. during surgery for six hours |
|
| Intravenous tranexamic acid | Drug | 50 mg/kg |
|
| infusion tranexamic acid | Drug | 1mg/kg/hr infusionfor 6 hours |
|
| topical tranexamic acid | Drug | 50 mg/kg added to the normal saline 2 ml/kg into the pericardial cavity before sternal closure |
|
| topical normal saline | Drug | 2 ml/kg into the pericardial cavity before sternal closure |
|
| within the first 24 hours |
| the length of ICU stay | by days | within the first month |
| D000077324 |
| Crystalloid Solutions |
| D007552 | Isotonic Solutions |
| D012996 | Solutions |
| D004364 | Pharmaceutical Preparations |