The Practice of Routine Extended Perioperative Administration of Fibrinolysis Inhibitors to Reduce the Risk of Bleeding in Cardiac Surgery Multicenter Prospective Randomized Cluster Crossover Study

What this Trial Is About

Researchers are investigating the best way to use fibrinolysis inhibitors during and after open heart surgery to reduce the need for blood transfusions. This trial compares two approaches: using fibrinolysis inhibitors only during surgery versus extending their use into the postoperative period. The study aims to clarify the optimal dosing and timing since current practices vary widely and previous small studies have not conclusively shown the benefits of extended use. Participants will be assigned to one of two groups based on hospital policy. One group will receive the full routine dose of fibrinolysis inhibitors intravenously during surgery only. The other group will get 70% of the routine dose during surgery and the remaining 30% as an intravenous infusion during the first four hours after surgery. This extended administration is being evaluated for its potential to better manage bleeding and reduce transfusions. During the hospital stay, researchers will monitor the amount of red blood cell transfusions needed, length of hospital stay, any need for repeat surgery, hemoglobin levels at discharge, and total blood product use. These outcomes will be assessed up to 12 months after admission or until discharge or death. The study involves multiple centers with high volumes of cardiac surgeries and follows patients through their hospitalization to measure the effects of the different fibrinolysis inhibitor dosing strategies.

Extended Perioperative Administration of Fibrinolysis Inhibitors After Cardiac Surgery