Tranexamic Acid In Blood Loss Research Articles

The role of intravenous tranexamic acid for blood loss in total hip arthroplasty secondary to femoral neck fracture

Aim: The aim of the study was to compare the efficacy of intravenous (IV) administration of tranexamic acid (TXA) in terms of bleeding volume, allogeneic blood transfusion (ABT) requirement, and complications in total hip arthroplasty (THA) secondary to osteoporotic femoral neck fracture (FNF).
 Material and Method: A total of 165 patients who underwent THA on the background of FNF in our clinic were included in the study. Patients' demographic data, preoperative and postoperative blood parameters, the amount of blood loss calculated according to the Nadler formula, amount of ABT, and complications at the 90-day follow-up were recorded. The patients were divided into two groups those who received 15mg/kg preoperatively and 10mg/kg IV TXA at the end of the operation (TXA group-89 patients) and those who did not receive TXA (Control group-76 patients) and the two groups were compared.
 Results: The total amount of bleeding calculated according to the Nadler formula was significantly less in the TXA group (1659,68±320,86ml) compared with the Control group (1774,43±365,24ml) (p=0.033). The need for ABT was 42.86% in the TXA group and 57.14% in the control group, and this difference was statistically significant (p=0.008).
 Conclusion: In patients who underwent THA on the basis of osteoporotic FNF, preoperative and postoperative administration of 2 doses of IV TXA significantly reduced total blood loss and the need for ABT. We suggest that IV TXA administration can be safely performed, especially in this patient group, to reduce the amount of bleeding and therefore the need for ABT by not increasing any thromboembolic complications.

Comparison of weight-based versus standard dosing of tranexamic acid for blood loss and transfusion amount in knee arthroplasty without tourniquet.

The aim of the study is to compare weight-based versus standard dosing of intravenous (IV) tranexamic acid (TXA) for blood loss and transfusion amount in total knee arthroplasty (TKA) without a tourniquet. A total of 99 patients were divided into two groups: Group 1 (standard): 1 g of IV TXA 30 min before skin incision, and 1 g at postoperative 30 min and 3 h. Group 2 (weight-based): 10 mg/kg IV TXA 30 min before the skin incision, and 10 mg/kg at postoperative 30 min, and 3 h. Hemoglobin levels, before, and 1, and 2 days after the operation, postoperative amount of decrease in hemoglobin levels, and amount of erythrocyte transfusion were recorded. Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and Knee Society Score (KSS) were applied in the evaluation of TKA results preoperatively, and at 1., 3., 6., and 12. months, postoperatively. In both study groups, hemoglobin levels in male patients dropped significantly more deeply than female patients. Also, in both study groups, hemo- globin levels were significantly lower in patients with comorbid illnesses. A statistically significant difference was not detected between both groups in terms of pre- and postoperative WOMAC scores, KSS knee scores, and KSS function scores. Our study showed that standard and weight-based dosing of IV TXA treatments were similar in efficacy and safety. Both treatments reduce blood loss and the need for transfusion. Also, there was no significant difference in terms of reliability between two groups.

The efficacy of combined intra-articular and intravenous tranexamic acid for blood loss in primary total knee arthroplasty: A meta-analysis.

Background:This meta-analysis aimed to illustrate the efficacy and safety of combined topical and intravenous (IV) tranexamic acid (TXA) for blood loss control in primary total knee arthroplasty (TKA) patients.Methods:In April 2017, a systematic computer-based search was conducted in PubMed, EMBASE, Web of Science, Cochrane Database of Systematic Reviews, and Google database. Data on patients prepared for TKA surgery in studies that compared combined topical and IV TXA versus placebo, topical, or IV TXA alone were retrieved. The primary endpoint was the need for transfusion, total blood loss, hemoglobin drop, and the occurrence of deep venous thrombosis (DVT), pulmonary embolism (PE), and the infection. After testing for publication bias and heterogeneity between studies, data were aggregated for random-effects models when necessary.Results:Seven clinical studies were ultimately included in the meta-analysis. Compared with IV TXA and control group, combined TXA was associated with less need for transfusion, blood loss, and hemoglobin drop (P < .05). There was no significant difference between the combined TXA and topical TXA in terms of the need for transfusion, total blood loss, and hemoglobin drop (P > .05). There was no significant difference between the complications (DVT, PE, and infection) between the combined TXA, IV TXA, topical TXA, and control group.Conclusions:Current meta-analysis suggests that the combined IV and topical TXA was superior than IV TXA or control group. There is still need for more studies to identify whether combined TXA was superior than topical TXA alone.

Efficacy of tranexamic acid in blood loss in posterior lumbar inter-body fusion

Efficacy of tranexamic acid in blood loss in posterior lumbar inter-body fusion

The effect of tranexamic acid in blood loss and transfusion volume in adolescent idiopathic scoliosis surgery: A single-surgeon experience

Intraoperative blood loss in scoliosis surgery often requires transfusions. Autogenous blood decreases but does not eliminate risks typically associated with allogenic blood transfusion. Costs associated with transfusions are significant. Tranexamic acid (TXA) has been shown to decrease blood loss in cardiac and joint surgery. Few studies have examined its use in pediatric spine surgery, and the results are inconsistent. The aim of this study was to determine whether TXA decreases intraoperative blood loss and transfusion requirements in adolescent idiopathic scoliosis patients undergoing posterior spinal fusion by a single surgeon. The medical records and operative reports of surgically treated patients with adolescent idiopathic scoliosis between 2000 and 2009 were retrospectively reviewed. The inclusion criteria were: (1) patients who underwent instrumented posterior spinal fusion, (2) had complete medical records, and (3) were treated by the same surgeon. Forty-nine patients who met the inclusion criteria were divided into two groups: Group A (25 patients) received TXA, while Group B (24 patients) did not receive TXA. After controlling for age at the time of surgery, gender, and number of vertebral levels fused, the mean intraoperative blood loss was significantly lower in Group A (537ml) than in Group B (1,245ml) (p=0.027). The mean volume of blood transfused intraoperatively was 426 and 740ml for Group A and Group B, respectively. The difference was not statistically significant after controlling for age, gender, and number of levels fused (p=0.078). TXA significantly decreased intraoperative blood loss in posterior spinal fusions performed for adolescent idiopathic scoliosis.

Efficacy of Prophylactic Tranexamic Acid for Blood Loss in Spinal Surgery

Efficacy of Prophylactic Tranexamic Acid for Blood Loss in Spinal Surgery

当院での人工膝関節置換術(TKA)術後出血におけるトラネキサム酸(TA)の有効性

当院での人工膝関節置換術(TKA)術後出血におけるトラネキサム酸(TA)の有効性