Ketorolac Reduces ICU Stay and Bleeding in Aortic Dissection Patients, confirms study

Patients were monitored closely, with the main endpoints being safety and efficacy, with an emphasis on mortality and organ malperfusion incidence. Secondary endpoints were drug-related adverse events, intraoperative bleeding, duration of ICU stay, and hospital cost. Of 110 randomly assigned patients, one from the ketorolac group withdrew due to erythroderma, resulting in 54 patients in the ketorolac group and 55 in the placebo group being available for final analysis.

Key Findings

Although the two groups were similar in terms of the main outcomes of mortality and organ malperfusion, several secondary benefits occurred in the ketorolac group:

Intraoperative bleeding:

• Ketorolac group: Median of 1.8 liters

• Placebo group: Median of 2.0 liters

• Statistical significance: P = 0.03

Duration of stay in the ICU:

• Ketorolac group: Median of 6.5 days

• Placebo group: Median of 8 days

• Statistical significance: P = 0.04

Hospital costs:

Total hospital costs:

• Ketorolac group: Median of ¥170,430

• Placebo group: Median of ¥187,730

• Statistical significance: P = 0.03

• No increase in drug-related adverse effects was significant, and the overall safety profile of ketorolac was acceptable throughout the perioperative period.

Short-term administration of ketorolac in acute Type A aortic dissection patients did not affect primary outcomes such as mortality and organ malperfusion, but it resulted in substantial decreases in intraoperative bleeding, ICU stay time, and hospitalization expense. These findings affirm the safety and peroperative potential of ketorolac in aTAAD treatment.

Reference:

Lv, ZK., Zhang, HT., Cai, XJ. et al. Ketorolac in the perioperative management of acute type A aortic dissection: a randomized double-blind placebo-controlled trial. BMC Med 23, 188 (2025). https://doi.org/10.1186/s12916-025-04021-1