Individuals who undergo spine surgery often have a significant loss of blood and may require multiple blood transfusions. Research has shown that epsilon-aminocaproic acid (EACA) may reduce the amount of blood lost during surgery, which would decrease the number of blood transfusions required. This study will evaluate the safety and effectiveness of EACA at reducing blood loss and the need for blood transfusions in individuals undergoing spine surgery.
Spine surgery is often required to correct a number of diseases, including spondylosis, pseudoarthrosis, scoliosis, or other spinal deformities. Spine surgery is often associated with significant blood loss and individuals may require multiple blood transfusions during and following surgery. Blood transfusions are expensive and carry an increased risk of health complications, including fever, allergic reactions, or infections. Preliminary research has shown that EACA may be beneficial for individuals undergoing spine surgery. In addition, EACA appears to be safer and less expensive than other medications typically used to treat serious bleeding. The purpose of this study is to evaluate the safety and effectiveness of EACA at reducing the number of blood transfusions required during and following spine surgery in adults. This study will enroll individuals who are undergoing spine surgery at Johns Hopkins Hospital. Prior to surgery, participants' demographic data and medical history will be collected. Participants will then be randomly assigned to receive either EACA or placebo intravenously during surgery and for 8 hours following surgery in the intensive care unit (ICU). While in the hospital, participants will have blood drawn frequently for laboratory testing. They will receive blood transfusions as needed and will be closely monitored for blood loss and any medical, surgical, or transfusion complications. Outcome measurements related to the amount of transfused blood required and postoperative complications will be collected on the 8th day following surgery. Study participation will end on the day of hospital discharge or the day of a necessary second surgery.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
DOUBLE
Enrollment
182
Participants will receive EACA intravenously during surgery and for 8 hours following surgery in the intensive care unit (ICU).
Participants will receive placebo intravenously during surgery and for 8 hours following surgery in the intensive care unit (ICU).
Johns Hopkins Hospital
Baltimore, Maryland, United States
Number of allogenic blood units transfused
Time frame: Measured through the 8th postoperative day
Intraoperative and postoperative blood loss
Time frame: Measured through the 8th postoperative day
Intraoperative and postoperative blood products received, including autologous blood, allogenic blood, fresh frozen plasma, platelets, or cryo
Time frame: Measured through the 8th postoperative day
Potential complications of transfusion
Time frame: Measured through the 8th postoperative day
Potential complications of EACA
Time frame: Measured through the 8th postoperative day
Potential surgical complications
Time frame: Measured through the 8th postoperative day
Duration of mechanical ventilation
Time frame: Measured through the 8th postoperative day
In-hospital mortality
Time frame: Measured through the 8th postoperative day
ICU length of stay (LOS)
Time frame: Measured through the 8th postoperative day
Hospital LOS
Time frame: Measured through the 8th postoperative day
Direct costs of hospital care
Time frame: Measured through the 8th postoperative day
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