Abstract
ContextAcute pulmonary embolism (PE) is a lethal sequela of venous thromboembolism (VTE). Surgical trauma injures the tissue directly, releasing a large number of tissue agent. The frequency of re-exploration owing to bleeding after lung surgery is between 1 and 3.7%, whereas the need of allogenic blood transfusion spans from 20 to 52%.AimsTo assess the role of tranexamic acid (TXA) in reducing the need of allogenic blood transfusion in patients undergoing elective lung surgery.Patients and methodsThis retrospective study was conducted on 140 patients who underwent elective lung surgery. Patients were allocated into two groups. Group I patients received TXA at the end of procedure, and group II patients received blood and/or blood product transfusion.Statistical analysisQualitative variables are expressed as mean±SD. Quantitative variables are compared by using the Student’s t test.ResultsThe patients comprised 80 males and 60 females in our series. All cases in group II needed transfusion of one or more of the following: concentrated red blood cells, whole blood, fresh frozen plasma, and platelets. There was an obvious decrease in the postoperative hemoglobin level between groups, in favor of blood transfusion group (group II), and this was statistically significant.ConclusionsElective thoracic surgery patients have a low incidence of VTE and PE (2.85 and 2.14%, respectively). Hence, TXA helps in minimizing not only transfusion-related hazards but also operative cost.
Highlights
Acute pulmonary embolism (PE) is a lethal sequela of venous thromboembolism (VTE), which if not actively suspected and adequately treated might be a sufficient cause of death
There was an obvious decrease in the postoperative hemoglobin level between groups, in favor of blood transfusion group, and this was statistically significant
Our results demonstrated that the amount of blood loss during the first postoperative day is significantly reduced in group I (TXA) compared with patients in group II (BT)
Summary
Acute pulmonary embolism (PE) is a lethal sequela of venous thromboembolism (VTE), which if not actively suspected and adequately treated might be a sufficient cause of death. Postoperative PE may reach 5% in some patients subjected to a high thrombotic danger [2]. PErelated mortality reaches up to 30% in neglected patients with PE, whereas it can be as low as 2–10% in timely managed patients; it is the most widely recognized reason of preventable death in hospital [3]. Surgical trauma injures the tissue directly, releasing an enormous amount of tissue agents, which enter the circulation in a brief time and initiate the exogenous coagulation system. Surgical operation destructs and exposes elements such as subcutaneous collagen; endogenous coagulation cascade becomes activated [4]. The frequency of re-exploration for bleeding after thoracic surgery is between 1 and
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