The value of ethamsylate in hemostasis in patients with multiple pelvic fractures

Abstract

Multiple pelvic fractures are associated with large amounts of blood loss and the development of hemorrhagic shock due to injury. We included in our study 40 patients with polytrauma who had multiple pelvic fractures. Surgical correction consisted of external metal osteosynthesis of the pelvic bones to stabilize it and reduce the rate of blood loss. We set the goal of our work comparative study the effect of two options for hemostatic therapy using antifibrinolytic drugs. The first treatment option, which we used in 20 patients, included the use of tranexamic acid at a dose of 15 mg/kg during surgery, and then tranexamic acid had administered twice at 500 mg until the end of the first day after the patient received injury. The second treatment option, which we used in the other 20 patients, included, in addition to tranexamic acid, the administration of ethamsylate at a dose of 1000 mg during surgery, and then 250-500 mg after surgery every 4 hours. The components of fluid resuscitation did not differ between patients in the two groups. We have focused on the primary use of fresh frozen plasma and red blood cells. We preferably used colloidal solutions as plasma-substituting solutions. After 24 hours of observation, we assessed the dynamics of changes in hemoconcentration parameters and calculated the total volume of fluid administered per day. We did not find any benefit from the combined use of tranexamic acid and ethamsylate in patients with pelvic fractures.