Does Tranexamic Acid Reduce Blood Loss and Transfusion Requirements Associated With the Periacetabular Osteotomy?

Aims Tranexamic acid (TXA) has been shown to reduce blood loss and transfusion requirements in patients undergoing orthopaedic surgery. There remains a lack of prospective evidence for the use of TXA in patients undergoing periacetabular osteotomy (PAO). The purpose of this study was to determine if intravenous (IV) TXA is effective in reducing calculated blood loss and transfusions after PAO. Methods This was a single-centre prospective double-blind placebo-controlled randomized trial of 81 patients aged 12 to 45 years undergoing elective PAO by a single surgeon. The intervention group (n = 40) received two doses of IV TXA of a maximum 1 g in each dose; the control group (n = 41) received two doses of 50 ml 0.9% saline IV. The primary outcome was perioperative calculated blood loss. Secondary outcomes included allogenic transfusions and six-week postoperative complications. Results There were no differences in demographics or intraoperative variables between study groups. The TXA group demonstrated lower mean calculated blood loss (1,265 ml, (SD 321) vs 1,515 ml, (SD 394); p = 0.002) and lower frequency of allogenic transfusion (10%/n = 4 vs 37%/n = 15; p = 0.008). Regression analyses associated TXA use with significant reductions in calculated blood loss (p < 0.001) and transfusion (p = 0.007) after adjusting for age, sex, body mass index, preoperative haemoglobin, cell-saver volume, intraoperative mean arterial blood pressure, and operating time. No patients suffered venous thromboembolic complications. Conclusion In this trial, IV TXA decreased postoperative calculated blood loss by 293 ml and reduced the frequency of allogenic transfusions by 73% (37% vs 10%) following PAO. TXA may be safe and effective for reducing blood loss in patients undergoing PAO. Cite this article: Bone Joint J 2020;102-B(9):1151–1157.

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Evaluation of tranexamic acid in reducing blood loss and transfusions in total knee replacement

International Journal of Research in Orthopaedics ◽

10.18203/issn.2455-4510.intjresorthop20193832 ◽

2019 ◽

Vol 5 (5) ◽

pp. 899

Author(s):

Mirza Atif Baig ◽

Srujith Kommera

Keyword(s):

Blood Loss ◽

Total Knee Replacement ◽

Tranexamic Acid ◽

Knee Replacement ◽

Acid Group ◽

Control Group ◽

Blood Transfusions ◽

Reduce Blood Loss ◽

Transfusion Requirements ◽

Total Knee

Background: Total knee replacement (TKR) is associated with substantial blood loss and thus the need for blood transfusions. Risks and costs of allogenic blood transfusions requires strategies to reduce blood loss in surgery. The objective of this study was to assess the efficacy of tranexamic acid treatment in reducing blood loss and blood transfusion requirements during TKR.Methods: A randomized controlled trial was conducted on 60 patients who were operated for unilateral TKR from January 2016 to January 2019 in Shadan Institute of Medical Sciences. 30 patients were in each control and study groups. In study group 12 mg/kg bolus of tranexamic acid was given as a slow IV dose, 40 minutes before deflation of tourniquet followed by 1.2 mg/kg/hr infusion for 12 hours with standard treatment of hospital and compared to the control group. Later blood loss was compared both intra and post operatively. Fall in haemoglobin after surgery was also compared.Results: Total blood loss in tranexamic acid group was 543.3±184.85 ml (control group 685.83±176.74 ml) which is statistically significant (p<0.05). Blood loss was markedly decreased in tranexamic acid group (379.16±174 ml in tranexamic acid vs. 513.33±143.89 ml in control group) statistically significant (p<0.05).Conclusions: Tranexamic acid is an effective strategy to reduce blood loss in patients undergoing total knee replacement and thus minimizing the need for blood transfusions.

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Does prophylactic tranexamic acid reduce blood loss in Indian women following vaginal delivery?

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20200057 ◽

2021 ◽

Vol 10 (2) ◽

pp. 497

Author(s):

Nivedhana Arthi P. ◽

Indu N. R. ◽

Jalakandan B.

Keyword(s):

Blood Transfusion ◽

Blood Loss ◽

Tranexamic Acid ◽

Vaginal Delivery ◽

Controlled Study ◽

Reduce Blood Loss ◽

Indian Women ◽

Estimated Blood Loss ◽

Transfusion Requirements ◽

Significant Difference

Background: Postpartum hemorrhage (PPH) accounts for 25% to 33% of obstetric deaths every year. Anemia is a cause and consequence of PPH. Despite intense efforts to prevent anemia, many Indian women labour with low hemoglobin levels. Tranexamic acid (TXA), an antifibrinolytic, have been demonstrated to reduce blood loss and transfusion requirements in various surgeries including cesarean section. Objectives were to study the efficacy of TXA in effectively reducing blood loss in Indian women following vaginal delivery.Methods: This randomized, double-blind, placebo-controlled study was conducted on 200 patients scheduled for vaginal delivery. In addition to oxytocin 10 units, group T received TXA 15 mg/kg and group P received normal saline administered over 5 minutes. Estimated blood loss, Hemoglobin deficit, need for additional uterotonics, need for blood transfusion, incidence of PPH and adverse events were noted.Results: The fall in hemoglobin was significantly higher in group P (p<0.00001). Estimated 24 hour blood loss was significantly higher by a mean blood volume of 86.99 ml in group P compared to group T (p<0.00001). The incidence of PPH was lower in group T (2.8% versus 11.3%). There were no significant difference in the need for supplementary uterotonics (9.9% versus 15.5%) and the incidence of blood transfusion (2.8% versus 8.5%). No adverse maternal and fetal outcomes were noted.Conclusions: To reduce blood loss following vaginal delivery, TXA may be safely recommended as standard adjunct to Oxytocin for regular management of third stage of labour, especially in developing countries like India.

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