The Effects of Different Doses of Tranexamic Acid Infusions on the Postoperative Outcomes of Pediatric Cardiovascular Surgery

Aim: There are still concerns about its benefits and possible risks in pediatric patients, as well as the dosage regimen, frequency, and form of tranexamic acid. In this study, the effects of different doses of tranexamic acid used in pediatric congenital heart surgery were investigated. Methods: The study was conducted between August 1, 2020 and April 30, 2021, by screening patient files and hospital data systems. Accordingly, patients in Group TXA-10 and Group TXA-25 were continuously administered 10 mg/kg/hour and 25 mg/kg/ hour tranexamic acid infusions, respectively, from the induction of anesthesia until their transfer to the intensive care unit. The groups were compared in terms of the amount of bleeding, blood products used, and postoperative complications. Results: Thirty-five patients were included in Group TXA-10, and 36 patients were included in Group TXA-25. There was no statistical difference between the groups in terms of gender, weight, height, or presence of cyanotic heart disease. The median post-pump activated clotting time in Group TXA-10 was significantly longer than in Group TXA-25 (153 vs. 141.5 seconds, p=0.003). There was no significant difference between the groups also in terms of the amount of bleeding; the median erythrocyte transfusion amount was 50 ml in both groups. The amount of fresh frozen plasma and platelets that needed to be transfused in Group TXA-10 was higher than in Group TXA-25, albeit not significantly. There was no difference between the groups in terms of postoperative complication rates. Conclusion: Tranexamic acid can be safely and effectively used in pediatric heart surgery cases with an infusion rate of 10 mg/kg/hour.