Cardiothoracic & vascular anesthesia
Point-of-care testing for tranexamic acid efficacy: a proof-of-concept study in cardiac surgical patients
Authors' conclusion
The TPA-test is sensitive to low concentrations of TXA and serves as a practical monitoring tool for postoperative fibrinolytic activity in cardiac surgery patients.
Study context
- Population
- Healthy volunteers (in vitro) and cardiac surgery patients undergoing cardiopulmonary bypass (CPB)plus 6 volunteers in vitro
- Participants
- 20 volunteers
- Outcome
- TXA inhibition of tPA-triggered fibrinolysis on the TPA-test (ClotPro®)
Methodological detailsin vitro evaluation, observational, proof-of-concept
- In vitro evaluation
- Observational
- Proof-of-concept
Main finding
As reported in the abstract
In vitro: Tissue plasminogen activator (tPA)-induced hyperfibrinolysis inhibited by tranexamic acid (TXA) in a concentration-dependent manner from
≥2 mg L-1
In vitro: complete inhibition at TXA
≥10 mg L-1
Patients: antifibrinolytic effect detectable after TXA bolus at end of CPB of
0.1 g
Patients: complete inhibition of fibrinolysis with TXA
≥0.5 g
Further findings
Renal function and TPA-test parameters · 18 h after surgery
- Fibrinolytic inhibition continued in patients with estimated glomerular filtration rate (eGFR) ≤30 ml min-1 1.73 m-2 (n)
- 4
- Correlation of eGFR with TPA-test parameters (r)
- 0.86-0.92
- P<0.0001
Original publication
Point-of-care testing for tranexamic acid efficacy: a proof-of-concept study in cardiac surgical patients. Br J Anaesth. Published 26 April 2024. doi:10.
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