Intravenous tranexamic acid reduces total blood loss in reverse total shoulder arthroplasty: a prospective, double-blinded, randomized, controlled trial

2017 ◽  
Vol 26 (8) ◽  
pp. 1383-1389 ◽  
Author(s):  
Alexander D. Vara ◽  
Denise M. Koueiter ◽  
Daphne E. Pinkas ◽  
Ashok Gowda ◽  
Brett P. Wiater ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Blood Loss ◽  
Tranexamic Acid ◽  
Shoulder Arthroplasty ◽  
Controlled Trial ◽  
Total Shoulder Arthroplasty ◽  
Total Blood ◽  
Randomized Controlled ◽  
Double Blinded ◽  
Reverse Total Shoulder

Single dose of tranexamic acid effectively reduces blood loss and transfusion rates in elderly patients undergoing surgery for hip fracture: a randomized controlled trial

2021 ◽  
Vol 103-B (3) ◽  
pp. 442-448
Author(s):  
Vasileios S. Nikolaou ◽  
Panagiotis Masouros ◽  
Themistoklis Floros ◽  
Efstathios Chronopoulos ◽  
Maria Skertsou ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Single Dose ◽  
Hip Fracture ◽  
Blood Loss ◽  
Elderly Patients ◽  
Tranexamic Acid ◽  
Controlled Trial ◽  
Total Blood ◽  
Subcapital Fracture ◽  
Randomized Controlled

Aims The aim of this study was to investigate the hypothesis that a single dose of tranexamic acid (TXA) would reduce blood loss and transfusion rates in elderly patients undergoing surgery for a subcapital or intertrochanteric (IT) fracture of the hip. Methods In this single-centre, randomized controlled trial, elderly patients undergoing surgery for a hip fracture, either hemiarthroplasty for a subcapital fracture or intramedullary nailing for an IT fracture, were screened for inclusion. Patients were randomly allocated to a study group using a sealed envelope. The TXA group consisted of 77 patients, (35 with a subcapital fracture and 42 with an IT fracture), and the control group consisted of 88 patients (29 with a subcapital fracture and 59 with an IT fracture). One dose of 15 mg/kg of intravenous (IV) TXA diluted in 100 ml normal saline (NS,) or one dose of IV placebo 100 ml NS were administered before the incision was made. The haemoglobin (Hb) concentration was measured before surgery and daily until the fourth postoperative day. The primary outcomes were the total blood loss and the rate of transfusion from the time of surgery to the fourth postoperative day. Results Homogeneity with respect to baseline characteristics was ensured between groups. The mean total blood loss was significantly lower in patients who received TXA (902.4 ml (-279.9 to 2,156.9) vs 1,226.3 ml (-269.7 to 3,429.7); p = 0.003), while the likelihood of requiring a transfusion of at least one unit of red blood cells was reduced by 22%. Subgroup analysis showed that these differences were larger in patients who had an IT fracture compared with those who had a subcapital fracture. Conclusion Elderly patients who undergo intramedullary nailing for an IT fracture can benefit from a single dose of 15 mg/kg TXA before the onset of surgery. A similar tendency was identified in patients undergoing hemiarthroplasty for a subcapital fracture but not to a statistically significant level. Cite this article: Bone Joint J 2021;103-B(3):442–448.

Pre-operative tranexemic acid vs. etamsylate in reducing blood loss during elective cesarean section: randomized controlled trial

2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Haitham Torky ◽  
El-Sayed El-Desouky ◽  
Ibrahim Abo-Elmagd ◽  
Attia Mohamed ◽  
Ahmad Abdalhamid ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Side Effects ◽  
Blood Loss ◽  
Cesarean Section ◽  
Tranexamic Acid ◽  
Controlled Trial ◽  
Elective Cesarean Section ◽  
Randomized Controlled ◽  
Elective Cesarean ◽  
Double Blinded

AbstractObjectivesTo investigate whether etamsylate may be an alternative to tranexamic acid in reduction of blood loss during elective cesarean section.MethodsProspective double-blinded multi-center randomized controlled trial involving 180 qualified women equally divided into three groups each containing 60 women received either tranexamic acid, etamsylate or placebo 20 min before elective cesarean section and blood loss was estimated.ResultsMean blood loss, cases needing blood transfusion and cases needing further interventions were significantly lower in tranexamic acid and etamsylate group than placebo group, while mean postoperative hemoglobin and hematocrite were significantly higher in both tranexamic acid and etamsylate as compared to placebo.ConclusionsEtamsylate is an effective second-line therapy (after tranexamic acid) in reducing blood loss during elective cesarean section with low risk of side effects, therefore, it can be an effective alternative to tranexamic acid in cases with contraindications or anticipated to be at high-risk of developing side effects from tranexamic acid.

scholarly journals Accelerated Shoulder Rehabilitation after Reverse Total Shoulder Arthroplasty for Atraumatic Osteoarthritis: Study Protocol for a Single Center Randomized Controlled Trial

2019 ◽  
Author(s):  
Avais Raja ◽  
Travis Cambronne ◽  
Michael R Walsh
Keyword(s):  
Randomized Controlled Trial ◽  
Shoulder Arthroplasty ◽  
Controlled Trial ◽  
Total Shoulder Arthroplasty ◽  
Reverse Total Shoulder Arthroplasty ◽  
Single Center ◽  
Randomized Controlled ◽  
Patient Reported ◽  
Shoulder Motion ◽  
Reverse Total Shoulder

Abstract Background Reverse total shoulder arthroplasty has been successful in patients suffering from advanced degenerative osteoarthritis with rotator cuff insufficiency. The currently practiced physical rehabilitation after a shoulder rehabilitation does not allow shoulder motion until 6 weeks post-operatively. These patients are required to be in a sling to assist the patient in immobilizing the operated shoulder. An accelerated rehabilitation with immediate active shoulder motion has not been studied in the setting of a revere total shoulder arthroplasty. Methods This is a single center and single surgeon operated, randomized controlled trial. The primary objective is to compare patient reported shoulder function using the American Shoulder and Elbow Society (ASES) score and shoulder range of motion in patients undergoing the traditional physical rehabilitation and accelerated shoulder rehabilitation post reverse total shoulder arthroplasty. Secondary outcomes will include the Simple Shoulder Test (SST) score, Patient Reported Outcome Information System (PROMIS) Global Health-10, radiological parameters and subscapularis tear on ultrasound. Discussion The study will assess the effectiveness of an accelerated shoulder rehabilitation with immediate active shoulder motion after a reverse total shoulder arthroplasty in patients with atraumatic osteoarthritis.

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