Epsilon Aminocaproic Acid (EACA) for the Reduction of Blood Loss in Total Hip Arthroplasty (THA)
Epsilon Aminocaproic Acid (EACA) for the Reduction of Blood Loss in Total Hip Arthroplasty (THA)
You are being asked to take part in this research study because you are scheduled to have
 total hip replacement (arthroplasty) surgery. The goal of this study is to evaluate the
 effectiveness of the drug, epsilon Aminocaproic Acid (EACA), in decreasing the need for
 patients to receive blood after surgery. Currently, EACA is approved by the Federal Drug
 Administration (FDA) to treat a patient who is bleeding. The investigators plan to use EACA
 to prevent bleeding during and after surgery; use of this drug as a means of preventing
 bleeding is not currently approved by the FDA.
The goal of this prospective randomized study is to evaluate the effectiveness of a drug,
 epsilon aminocaproic acid (EACA), in reducing the frequency of postoperative blood
 transfusion following primary total hip arthroplasty. In our institution, up to 40% of
 patients with a preoperative of 13.5 g/dl or less undergoing total hip arthroplasty will
 require a blood transfusion. Fibrinolytic drugs such as EACA and tranexamic acid (TA) have
 been shown to decrease blood loss during surgery and decrease the likelihood of blood
 transfusion during postoperative hospitalization.. Both drugs decrease the body's ability to
 break down a blood clot, thus pushing the balance of blood clot formation and breakdown
 towards clot formation. This mechanism can decrease the amount of blood loss during and after
 a surgical procedure. The haemostatic effect of EACA has been investigated in multiple
 studies with the majority showing a positive effect on postoperative hemoglobin levels and
 decreased blood transfusion rates. Though several studies exist revealing the effective and
 safe use of perioperative TA, a similar drug to EACA, there is a paucity of information on
 the use of EACA in total joint arthroplasty.
Inclusion Criteria:

 1. Scheduled for a primary total hip arthroplasty to be performed at the Mayo Clinic

 2. A preoperative hemoglobin between 10.0 and 13.5

 Exclusion Criteria:

 1. A preoperative hemoglobin less than 10.0 or greater than 13.5

 2. Revision arthroplasty;

 3. Arthroplasty performed for acute fracture

 4. Inability to obtain informed consent;

 5. Allergy to EACA

 6. Pregnancy

 7. History of coronary stenting < 6 months

 8. Heart valve replacement;

 9. Renal disease,

 10. Coagulopathy, DIC,

 11. embolic stroke