Fig. 6.
Simulated bleeding and seizure events. The following tranexamic acid regimens were simulated: 100 mg/kg preoperative loading dose (blue dashed line and blue triangle); 30 mg/kg preoperative loading dose followed by 16 mg · kg–1 · h–1 during surgery with a further 2 mg/kg added to the cardiopulmonary bypass (CPB) pump prime (red solid line and red triangle for 3 h of surgery, red circle for 4 h of surgery); 10 mg/kg preoperative loading dose followed by 1 mg · kg–1 · h–1 for 12 h (green solid line and green circle); 20 mg/kg preoperative loading dose (yellow dashed line and yellow triangle). Top left, Predicted concentrations of tranexamic acid for various regimens indicated as described above, the dark gray column representing the mean duration of CPB in the meta-analysis. Top right, Predicted postoperative mediastinal blood loss without tranexamic acid (gray solid line) and for the different tranexamic acid regimens indicated as described above. Bottom, As a function of the mean tranexamic acid concentration from start of surgery up to 12 h, the probability of erythrocyte transfusion (left) and of seizure (right). Bottom right, The black solid line represents model-based study-level predictions of a hypothetical trial of patients undergoing coronary artery bypass grafting with a mean duration of surgery and CPB of 3 h and 1.5 h, respectively; the black dot-dash line represents model-based predictions at the study level of a hypothetical trial in patients undergoing open-chamber surgery with a mean duration of surgery and CPB of 4 h and 2.5 h, respectively; the average weight was 74 kg.