Measurement of Tranexamic Acid Serum Concentrations in a 7-Month-Old Infant With Clinical Seizures After Open Heart Surgery

The lysine analogue tranexamic acid (TXA) is the most commonly used antifibrinolytic drug in adult and in pediatric cardiac surgery, although an association between TXA and postoperative seizures was found in an adult cohort. 1 Martin K. Knorr J. Breuer T. et al. Seizures after open heart surgery: comparison of ε-aminocaproic acid and tranexamic acid. J Cardiothorac Vasc Anesth. 2011; 25: 20-25 Abstract Full Text Full Text PDF PubMed Scopus (99) Google Scholar Because of the lack of pharmacokinetic data in pediatric cardiac surgical patients, only empiric protocols for antifibrinolytic prophylaxis are used in daily clinical practice. 2 Eaton M.P. Antifibrinolytic therapy in surgery for congenital heart disease. Anesth Analg. 2008; 106: 1087-1100 Crossref PubMed Scopus (86) Google Scholar We report a 7-month-old infant who underwent cardiac surgery with the use of TXA and suffered several seizures during the early postoperative course. In this patient, TXA serum concentrations were systematically measured according to a study protocol analyzing pharmacokinetic parameters in pediatric patients up to 6 hours after start of the extracorporeal circulation.