Effect of administration of tranexamic acid on blood loss and transfusion requirements in children undergoing posterior fossa tumor excision: a retrospective cohort study.

Abstract

Surgical resection of posterior fossa tumors (PFT) in the pediatric age group often results in significant intraoperative blood loss. The primary objective was to assess the effect of tranexamic acid (TXA) on blood loss and transfusion requirement in pediatricpatients undergoing excision of PFT. In this retrospective study, all pediatric patients ≤ 18years, who underwent PFT resection over a period of 7years, were included. The patient and surgical characteristics, estimated blood loss (EBL), the need for blood and blood product transfusion, use of crystalloids, vasopressors, and any adverse events like seizures and thromboembolic events were recorded and compared between Group A who received TXA andGroup B who did not. The study included 50 patients, out of which 36 belonged to Group A and 14 to Group B. The median age was 8years (IQR, 2-17) and the mean BMI was 16.46 ± 4.11kg/m2. The mean EBL was 224.29 ± 110.36ml in group A (n = 36) and 362 ± 180.11ml in group B (n = 14) (p = 0.007). The intraoperative volume of crystalloid use was significantly higher in group B (p = 0.04). The requirement of blood and blood product transfusion was similar between the groups, but the volume of blood transfusion per kg body weight was higher in group B, 8.3 (IQR, 6.7-11.1)ml/kg in Group Aversus 10.5 (IQR, 8.1-16.1) ml/kg in Group B (p-value 0.3). The rates of complications noted in the form of seizures and thromboembolic events were comparable. The use of TXA in the pediatric population undergoing PFT resection aids in reducing blood loss during the surgery without increasing complications.