Year : 2012  |  Volume : 15  |  Issue : 1  |  Page : 6--12

Risk factors associated with postoperative seizures in patients undergoing cardiac surgery who received tranexamic acid: A case-control study


Felix R Montes1, Daniel F Pardo1, Marisol Carreņo2, Catalina Arciniegas1, Rodolfo J Dennis3, Juan P Umaņa2 
1 Department of Anaesthesiology, Fundacion CardioInfantil, Instituto de Cardiologia, Bogota, Colombia, South America
2 Department of Cardiovascular Surgery, Fundacion CardioInfantil, Instituto de Cardiologia, Bogota, Colombia, South America
3 Department of Internal Medicine, Fundacion CardioInfantil, Instituto de Cardiologia, Bogota, Colombia, South America

Correspondence Address:
Felix R Montes
Calle 163A # 13B-60, Bogota, Colombia
South America

Antifibrinolytic agents are used during cardiac surgery to minimize bleeding and reduce exposure to blood products. Several reports suggest that tranexamic acid (TA) can induce seizure activity in the postoperative period. To examine factors associated with postoperative seizures in patients undergoing cardiac surgery who received TA. University-affiliated hospital. Case-control study. Patients undergoing cardiac surgery with cardiopulmonary bypass (CPB) between January 2008 and December 2009 were identified. During this time, all patients undergoing heart surgery with CPB received TA. Cases were defined as patients who developed seizures that required initiation of anticonvulsive therapy within 48 h of surgery. Exclusion criteria included subjects with preexisting epilepsy and patients in whom the convulsive episode was secondary to a new ischemic lesion on brain imaging. Controls who did not develop seizures were randomly selected from the initial cohort. From an initial cohort of 903 patients, we identified 32 patients with postoperative seizures. Four patients were excluded. Twenty-eight cases and 112 controls were analyzed. Cases were more likely to have a history of renal impairment and higher preoperative creatinine values compared with controls (1.39 ± 1.1 vs. 0.98 ± 0.02 mg/dL, P = 0.02). Significant differences in the intensive care unit, postoperative and total lengths of stay were observed. An association between high preoperative creatinine value and postoperative seizure was identified. TA may be associated with the development of postoperative seizures in patients with renal dysfunction. Doses of TA should be reduced or even avoided in this population.


How to cite this article:
Montes FR, Pardo DF, Carreņo M, Arciniegas C, Dennis RJ, Umaņa JP. Risk factors associated with postoperative seizures in patients undergoing cardiac surgery who received tranexamic acid: A case-control study.Ann Card Anaesth 2012;15:6-12


How to cite this URL:
Montes FR, Pardo DF, Carreņo M, Arciniegas C, Dennis RJ, Umaņa JP. Risk factors associated with postoperative seizures in patients undergoing cardiac surgery who received tranexamic acid: A case-control study. Ann Card Anaesth [serial online] 2012 [cited 2020 Jun 3 ];15:6-12
Available from: http://www.annals.in/article.asp?issn=0971-9784;year=2012;volume=15;issue=1;spage=6;epage=12;aulast=Montes;type=0