scholarly journals Effect of High Dose Tranexamic Acid and Etamsylate in Reducing Blood Loss during Trans-Urethral Resection of Prostate, Bladder Tumours and Percutaneous Nephrolithotomy

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
A M Safan ◽  
M Samir ◽  
A M Saeed ◽  
A S I Farag
Keyword(s):  
Side Effects ◽  
Blood Loss ◽  
Tranexamic Acid ◽  
Vital Role ◽  
Control Group ◽  
High Dose ◽  
University Hospitals ◽  
Dose Combination ◽  
Group 2 ◽  
Control Study

Abstract Background Bleeding is one of the most serious events that can occur intra-operative as well as post-operative in TURP, TURBT, PCNL and minimizing blood loss is of vital role in preventing or reducing morbidity and mortality following these procedures. Aim of the Work The aim of the present study was to to evaluate the efficacy of high dose tranexamic acid and etamsylate in reducing blood Loss during TURP, PCNL, TURBT and to determine if we can use them as a routine or not. Patient and Methods The study, was a prospective randomized control study, would be conducted on 70 patients admitted through the outpatient urology clinic in Ain shams University Hospitals and Nasser institute hospital. The 70 patients were divided into two main groups. Each one was 35 patients, each group is subdivided into 3 subgroups ((a)TURP,(b)PCNL AND (c)TURBT). Group 1 (all did not receive the combination of high dose tranexamic acid and ethamsylate) Group 2 (all received the combination of high dose tranexamic acid 2g per day and ethamsylate2.5g per day). Results We found that hemoglobin and hematocrit drop was significantly smaller in cases group and subgroups compared with the control group and subgroups, we also found that blood transfusion is reduced in control group and subgroups than in cases. Also procedure time was highly significant decreased in cases compared with controls. the high dose combination tranexamic acid 2g per day and ethamsylate2.5g per day was found to be safe without side effects especially thromboembolic side effects. Conclusion The study showed that High dose tranexamic acid and etamsylate is safe and effective in reducing blood loss during TURP,PCNL and TURBT. but we still cannot use them as a routine in all patients because our study is conducted on patients with selected criteria so further studies are needed.

scholarly journals High-dose tranexamic acid reduces intraoperative and postoperative blood loss in posterior lumbar interbody fusion

2017 ◽  
Vol 26 (3) ◽  
pp. 363-367 ◽  
Author(s):  
Junichi Kushioka ◽  
Tomoya Yamashita ◽  
Shinya Okuda ◽  
Takafumi Maeno ◽  
Tomiya Matsumoto ◽  
...  
Keyword(s):  
Blood Loss ◽  
Tranexamic Acid ◽  
Interbody Fusion ◽  
Surgical Techniques ◽  
Posterior Lumbar Interbody Fusion ◽  
Postoperative Blood Loss ◽  
Control Group ◽  
High Dose ◽  
Lumbar Interbody Fusion ◽  
Single Level

OBJECTIVE Tranexamic acid (TXA), a synthetic antifibrinolytic drug, has been reported to reduce blood loss in orthopedic surgery, but there have been few reports of its use in spine surgery. Previous studies included limitations in terms of different TXA dose regimens, different levels and numbers of fused segments, and different surgical techniques. Therefore, the authors decided to strictly limit TXA dose regimens, surgical techniques, and fused segments in this study. There have been no reports of using TXA for prevention of intraoperative and postoperative blood loss in posterior lumbar interbody fusion (PLIF). The purpose of the study was to evaluate the efficacy of high-dose TXA in reducing blood loss and its safety during single-level PLIF. METHODS The study was a nonrandomized, case-controlled trial. Sixty consecutive patients underwent single-level PLIF at a single institution. The first 30 patients did not receive TXA. The next 30 patients received 2000 mg of intravenous TXA 15 minutes before the skin incision was performed and received the same dose again 16 hours after the surgery. Intra- and postoperative blood loss was compared between the groups. RESULTS There were no statistically significant differences in preoperative parameters of age, sex, body mass index, preoperative diagnosis, or operating time. The TXA group experienced significantly less intraoperative blood loss (mean 253 ml) compared with the control group (mean 415 ml; p < 0.01). The TXA group also had significantly less postoperative blood loss over 40 hours (mean 321 ml) compared with the control group (mean 668 ml; p < 0.01). Total blood loss in the TXA group (mean 574 ml) was significantly lower than in the control group (mean 1080 ml; p < 0.01). From 2 hours to 40 hours, postoperative blood loss in the TXA group was consistently significantly lower. There were no perioperative complications, including thromboembolic events. CONCLUSIONS High-dose TXA significantly reduced both intra- and postoperative blood loss without causing any complications during or after single-level PLIF.

scholarly journals Effectiveness of tranexamic acid in reducing blood loss in cervical laminoplasty: A retrospective observational study

2020 ◽  
Vol 27 (2) ◽  
pp. 162-165
Author(s):  
Chi-Hei Ho ◽  
Raymond Nang-Man Wong
Keyword(s):  
Body Mass Index ◽  
Blood Loss ◽  
Tranexamic Acid ◽  
Operating Time ◽  
Postoperative Blood Loss ◽  
Control Group ◽  
Cervical Laminoplasty ◽  
Thromboembolic Complications ◽  
Perioperative Blood Loss ◽  
Control Study

Background: Tranexamic acid (TXA) has been proved effective in reducing perioperative blood loss in patients undergoing orthopedic operations. However, given the heterogeneity in the diagnoses and spinal operations, there are only limited studies comparing patients with uniform diagnoses and procedures performed. Methods: A comparative observational control study was performed on 62 patients with cervical myelopathy. They were divided into control (32) and TXA (30) groups according to whether they had received TXA before and during surgery. Cervical laminoplasty from C3 to C6/7 was performed for all patients using a consistent procedure. Preoperative and postoperative hematological data and perioperative blood loss were compared. Results: There were no statistically significant differences between the two groups in terms of age, gender, body mass index, and operating time. The TXA group had significantly less intraoperative (310 ± 215 ml vs. 144 ± 90 ml, p < 0.05) and postoperative blood loss than the control group (150 ± 50 ml vs. 249 ± 94 ml, p < 0.01). The drop of hemoglobin (Hb) level in the TXA group was also significantly lower (0.5 ± 0.42 g/dl vs. 2.1 ± 1.03 g/dl, p < 0.01). No thromboembolic complications found. Conclusion: TXA significantly reduced perioperative blood loss and reduced drop of postoperative Hb level in cervical laminoplasty.

scholarly journals A randomized control trial to evaluate the effectiveness of intravenous, intra-articular and topical wash regimes of tranexamic acid in primary total knee arthroplasty

2017 ◽  
Vol 25 (1) ◽  
pp. 230949901769352 ◽  
Author(s):  
Jatin Prakash ◽  
Jong-Keun Seon ◽  
Yong Jin Park ◽  
Cheng Jin ◽  
Eun-Kyoo Song
Keyword(s):  
Blood Transfusion ◽  
Blood Loss ◽  
Tranexamic Acid ◽  
Primary Total Knee Arthroplasty ◽  
Acid Group ◽  
Control Group ◽  
Operative Blood Loss ◽  
Mode Of Administration ◽  
Transfusion Requirements ◽  
Group 2

Background: The efficacy of tranexamic acid to decrease post-operative blood loss and blood transfusion is well established in literature. However, the ideal mode of administration is debatable. Limited literature has compared all the available modes of administration including intravenous (IV), topical irrigation and retrograde through drain. We hypothesized that no difference would be present in either form of administration of tranexamic acid. Methods: Fifty patients in four groups were enrolled for study. Group 1 received drug intravenously, group 2 had topical washing with drug before closure, group 3 received drug after closure through drain and group 4 was control that received no tranexamic acid. Post-operative blood loss, calculated blood loss, haemoglobin drop, transfusion requirements and complications were studied for all four groups. Results: Tranexamic acid results in lower bleeding irrespective of the mode of administration compared to control group. Total loss at end of 5 days is similar in all tranexamic acid groups irrespective of method used to deliver the drug. Calculated blood loss and haemoglobin drop was minimum for IV and in patients who were administered drug retrograde through drain. Requirement for blood transfusion was found to be lower in all tranexamic acid patients compared to non-tranexamic acid group. The requirement was highest in topical wash group among all tranexamic acid groups. Conclusion: We conclude that intra-articular administration through drain and IV administration are equally effective and superior to topical wash method in reducing blood loss, haemoglobin fall and transfusion requirements.

scholarly journals Assessment the role of tranexamic acid in prevention of postpartum hemorrhage

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Nevein Gerges Fahmy ◽  
Fahmy Saad Latif Eskandar ◽  
Walid Albasuony Mohammed Ahmed Khalil ◽  
Mohammed Ibrahim Ibrahim Sobhy ◽  
Amin Mohammed Al Ansary Amin
Keyword(s):  
Blood Loss ◽  
Cesarean Section ◽  
Tranexamic Acid ◽  
Postpartum Hemorrhage ◽  
Postoperative Bleeding ◽  
Control Group ◽  
Study Group ◽  
Mortality And Morbidity ◽  
Lower Segment Cesarean Section ◽  
Prophylactic Use

Abstract Background Postpartum hemorrhage (PPH) is one of the leading causes of maternal mortality and morbidity worldwide. It is believed that hemostatic imbalance secondary to release of tissue plasminogen activator (tPA) and subsequent hyperfibrinolysis plays a major role in PPH pathogenesis. Antifibrinolytic drugs such as tranexamic acid (TXA) are widely used in hemorrhagic conditions associated with hyperfibrinolysis. TXA reduced maternal death due to PPH and its use as a part of PPH treatment is recommended, and in recent years, a number of trials have investigated the efficacy of prophylactic use of TXA in reducing the incidence and the severity of PPH. The study is aiming to assess the efficacy of tranexamic acid in reducing blood loss throughout and after the lower segment cesarean section and reducing the risk of postpartum hemorrhage. Results The amount of blood loss was significantly lower in the study group than the control group (416.12±89.95 and 688.68±134.77 respectively). Also the 24-h postoperative hemoglobin was significantly higher in the study group (11.66±0.79 mg/dl) compared to the control group (10.53±1.07mg/dl), and the 24-h postoperative hematocrit value was significantly higher in the study group (34.99±2.40) compared to control (31.62±3.22). Conclusion Prophylactic administration of tranexamic acid reduces intraoperative and postoperative bleeding in cesarean section and the incidence of postpartum hemorrhage.

Antihyperlipidemic and Antiobesity potential of Aquilaria agallocha & Borago officinalis in Fixed Dose Combination; A Contingent Probe with Atorvastatin & Orlistat

2021 ◽  
Vol 17 ◽  
Author(s):  
Rohima Oraon ◽  
Tarique Mahmood ◽  
Arshiya Shamim ◽  
Farogh Ahsan ◽  
Mohammad Shariq ◽  
...  
Keyword(s):  
Weight Ratio ◽  
Good Control ◽  
Fixed Dose Combination ◽  
Atherogenic Index ◽  
Heart Weight ◽  
Fixed Dose ◽  
Control Group ◽  
High Dose ◽  
Borago Officinalis ◽  
Dose Combination

: Hyperlipidemia and Obesity have been an alarmingly rising health disorders for the past few decades worldwide. They eventually pave way for cardiovascular and other metabolic health risks that are manifested with elevated blood lipid levels. Atherosclerosis, Coronary artery disease and Cerebrovascular diseases, are some major complications of hyperlipidemia. The current clinically available drugs like, Statins & HMG-Co-A inhibitors have a good control on hyperlipidemia but present many insalubrious effects like myopathy & hepatotoxicity that questions their risk-benefit ratio. The current study was designed to develop a fixed-dose combination (FDC) of extracts of Aquilaria agallocha and Borago officinalis, to delve into therapeutic resources that have synergistic benefits and could overpower the adverse effects of modern therapy. These plants are well reported for cardioprotective, immunomodulatory and hepatoprotective potentials. The FDC developed with these plants was examined for its antihyperlipidemic and antiobesity potential in HFD fed animal model (Vijaya et al) for Hyperlipidemia. The extracts from leaves of Borago officinalis and Aquilaria agallocha were administered perorally for 28 days in a fixed dose combination (FDC) in HFD fed rats. The physical and the biochemical parameters; viz, the gross examination of liver, heart, heart weight/body weight ratio, atherogenic index, various hepatic & cardiac biomarker enzymes and serum lipid markers were scrutinized. The result of the study suggested that both the low and high dose of the FDC of Aquilaria agallocha & Borago officinalis has significant Anti-Hyperlipidemic and Anti-Obesity potential against High-fat diet-induced Hyperlipidemia and Obesity when compared to disease control group (at p<0.01 & p<0.001) and their effects were at par with clinically established drugs Atorvastatin & Orlistat.

scholarly journals Periarticular injection of tranexamic acid promotes early recovery of the range of knee motion after total knee arthroplasty

2019 ◽  
Vol 27 (3) ◽  
pp. 230949901986469
Author(s):  
Hitoshi Hirose ◽  
Hiroyasu Ogawa ◽  
Kazu Matsumoto ◽  
Haruhiko Akiyama
Keyword(s):  
Total Knee Arthroplasty ◽  
Blood Loss ◽  
Tranexamic Acid ◽  
Knee Arthroplasty ◽  
Control Group ◽  
Early Recovery ◽  
Periarticular Injection ◽  
Maximum Flexion ◽  
Maximum Flexion Angle ◽  
Total Knee

Purpose: Tranexamic acid (TXA) is a commonly used compound that reduces postoperative blood loss. Periarticular injection of TXA is a recently reported procedure with some advantages such as cost-effectiveness and the ease of performance over an intravenous or topical administration. However, its association with functional recovery remains unclear. This study aimed to examine the effect of periarticular injection of TXA on early postoperative recovery of knee functionality after total knee arthroplasty (TKA). Methods: Eighty-four patients who underwent primary unilateral TKA from February 2013 to August 2016 were classified into two groups based on whether they received TXA injection (44 cases each in the TXA and control groups). Patients in the TXA group received periarticular injection of TXA (1000 mg) just prior to incision closure. Ten-meter walk test (s), pain visual analog scale, knee extension muscle force (N), range of motion (ROM) (maximum flexion angle, maximum extension angle, and motion arc), and blood loss (mL) were assessed. Results: The maximum flexion angle and maximal extension angle on postoperative day (POD) 4, POD7, POD10, and POD14 in the TXA group were significantly larger than those in the control group. The postoperative drained blood in the TXA group was significantly less than that of the control group (543.9 ± 464.3 mL and 814.9 ± 481.4 mL, respectively, p < 0.05). No significant difference was observed in the other parameters at any time point. Conclusion: Periarticular injection of TXA significantly promotes early recovery of knee ROM after TKA. Level of Evidence: Level IV, therapeutic case series.

scholarly journals Check the effects: systematic assessment of antipsychotic side-effects in an inpatient cohort

2020 ◽  
Vol 10 ◽  
pp. 204512532095711
Author(s):  
Caroline Hynes ◽  
Stephen McWilliams ◽  
Mark Clarke ◽  
Ita Fitzgerald ◽  
Larkin Feeney ◽  
...  
Keyword(s):  
Side Effects ◽  
Rating Scales ◽  
Rating Scale ◽  
Standard Dose ◽  
Well Being ◽  
High Dose ◽  
Negative Consequences ◽  
Adherence Assessment ◽  
Dose Combination ◽  
Antipsychotic Side Effects

Background: Antipsychotics are associated with a range of side-effects that can influence patients’ subjective well-being negatively resulting in poor adherence. In order to limit the negative consequences of side-effects, they should be regularly systematically assessed. The aim of this study was to systematically assess antipsychotic side-effects in an inpatient cohort using validated rating scales. Methods: Eligible individuals prescribed an antipsychotic for at least 2 weeks were invited to have their side-effects assessed systematically. Results: A total of 208 individuals were assessed systematically for antipsychotic side-effects; 71.5% ( n = 138) stated that they had not reported side-effects to their clinician prior to the assessment. The most commonly reported side-effects were daytime drowsiness (75%), dry mouth (58.2%) and weight gain (50.0%), while the most distressing side-effects reported were erectile dysfunction (35.0%), sexual dysfunction (26.3%) and amenorrhoea (26.3%). There was no evidence of an association between side-effect severity/number of side-effects reported/distress caused by those taking high dose/combination antipsychotics versus standard dose monotherapy. Conclusion: Side-effects must be regularly and systematically assessed using a validated rating scale. As distress caused by side-effects plays a major role in non-adherence, assessment should examine distress and data on distressing side-effects should be available to those choosing an antipsychotic. Given the lack of correlation between high dose/combination antipsychotics and side-effects, treatment should be tailored to the individual based on response/tolerance and dose reduction/avoidance of polypharmacy should not be recommended to minimise side-effects.

Effect of Multiple Doses of Oral Tranexamic Acid on Haemostasis and Inflammatory Reaction in Total Hip Arthroplasty: A Randomized Controlled Trial

2018 ◽  
Vol 119 (01) ◽  
pp. 092-103 ◽  
Author(s):  
Duan Wang ◽  
Yang Yang ◽  
Chuan He ◽  
Ze-Yu Luo ◽  
Fu-Xing Pei ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Blood Loss ◽  
Inflammatory Response ◽  
Tranexamic Acid ◽  
Hip Arthroplasty ◽  
Multiple Dose ◽  
Control Group ◽  
Total Hip ◽  
Estimated Blood Loss ◽  
Significant Difference

AbstractTranexamic acid (TXA) reduces surgical blood loss and alleviates inflammatory response in total hip arthroplasty. However, studies have not identified an optimal regimen. The objective of this study was to identify the most effective regimen of multiple-dose oral TXA in achieving maximum reduction of blood loss and inflammatory response based on pharmacokinetic recommendations. We prospectively studied four multiple-dose regimens (60 patients each) with control group (group A: matching placebo). The four multiple-dose regimens included: 2-g oral TXA 2 hours pre-operatively followed by 1-g oral TXA 3 hours post-operatively (group B), 2-g oral TXA followed by 1-g oral TXA 3 and 7 hours post-operatively (group C), 2-g oral TXA followed by 1-g oral TXA 3, 7 and 11 hours post-operatively (group D) and 2-g oral TXA followed by 1-g oral TXA 3, 7, 11 and 15 hours post-operatively (group E). The primary endpoint was estimated blood loss on post-operative day (POD) 3. Secondary endpoints were thromboelastographic parameters, inflammatory components, function recovery and adverse events. Groups D and E had significantly less blood loss on POD 3, with no significant difference between the two groups. Group E had the most prolonged haemostatic effect, and all thromboelastographic parameters remained within normal ranges. Group E had the lowest levels of inflammatory cytokines and the greatest range of motion. No thromboembolic complications were observed. The post-operative four-dose regimen brings about maximum efficacy in reducing blood loss, alleviating inflammatory response and improving analgaesia and immediate recovery.

Tranexamic Acid Reduces Blood Loss, Transfusion Requirements, and Coagulation Factor Use in Primary Orthotopic Liver Transplantation

1996 ◽  
Vol 85 (5) ◽  
pp. 1043-1048 ◽  
Author(s):  
John F. Boylan ◽  
John R. Klinck ◽  
Alan N. Sandler ◽  
Ramiro Arellano ◽  
Paul D. Greig ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Liver Disease ◽  
Blood Loss ◽  
Tranexamic Acid ◽  
Orthotopic Liver Transplantation ◽  
Interquartile Range ◽  
High Dose ◽  
Intraoperative Blood Loss ◽  
End Stage ◽  
Donor Exposure

Background Patients with end-stage liver disease frequently incur large-volume blood loss during liver transplantation associated with mechanical factors, preexisting coagulopathy, and intraoperative fibrinolysis. Methods Between April 1992 and May 1994, the authors of this double-blind, randomized, placebo-controlled study examined the effect of high-dose tranexamic acid (maximum of 20 g) on blood loss and blood product requirements in patients undergoing primary isolated orthotopic liver transplantation. Primary outcome measures were volume of blood loss (intraoperative blood loss and postoperative drainage) and erythrocyte, plasma, platelet, and cryoprecipitate use during surgery and the first 24 h of intensive care unit stay. Results Patients receiving tranexamic acid (n = 25) had less intraoperative blood loss (median, 4.3 l; interquartile range, 2.5 to 7.9; P = 0.006) compared with the placebo group (n = 20; median, 8 l; interquartile range, 5 to 15.8), and reduced intraoperative plasma, platelet, and cryoprecipitate requirements. Median perioperative erythrocyte use was 9 units (interquantile range, 4 to 14 units) in patients receiving tranexamic acid and 13 units (interquantile range, 7.5 to 31 units) in controls (P = 0.03). Total perioperative donor exposure was 20.5 units (interquantile range, 16 to 41 units) in patients receiving tranexamic acid and 43.5 units (interquantile range, 29.5 to 79 units) in controls (P = 0.003). Results for postoperative wound drainage were similar. Hospital stay and need for retransplantation were comparable in both groups. No patient in either group showed clinical evidence of hepatic artery or portal venous thrombosis within 1 month of transplantation. Conclusions High-dose tranexamic acid significantly reduces intraoperative blood loss and perioperative donor exposure in patients with end-stage parenchymal liver disease who are undergoing orthotopic liver transplantation, with marked reductions in platelet and cryoprecipitate requirements.

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