• A&A practice · Nov 2023

    Case Reports

    Tranexamic Acid in Cardiac Surgery: A Case Report of an Infrequent Adverse Reaction to a Common Medication.

    • Lisa Sanchez Salcedo, Federico Manuel Baloira, Alejo Adrover, Juan C Bianco, and Maria Eugenia Garcia Guzzo.
    • From the Department of Anesthesiology, Hospital Italiano de Buenos Aires, Autonomous City of Buenos Aires, Buenos Aires, Argentina.
    • A A Pract. 2023 Nov 1; 17 (11): e01730e01730.

    AbstractLife-threatening anaphylaxis to tranexamic acid (TXA) is rare but critical in cardiac surgery. A 76-year-old patient undergoing elective ascending aorta replacement developed severe anaphylactic shock shortly after anesthesia induction. Subsequent skin prick tests confirmed a positive TXA reaction. While TXA and lysine derivatives were avoided in the second surgery, the patient experienced hyperfibrinolysis. Guided by rotational thromboelastometry, hemostatic therapy led to a successful outcome with minimal postoperative bleeding. This report emphasizes the importance of drug risk awareness and strategies to mitigate excessive bleeding in cardiac surgery.Copyright © 2023 International Anesthesia Research Society.

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