scholarly journals Effects of aminocaproic acid on perioperative hidden blood loss in elderly patients with femoral intertrochanteric fracture treated with proximal femoral nail anti-rotation

2019 ◽  
Vol 47 (10) ◽  
pp. 5010-5018 ◽  
Author(s):  
Rui Zhang ◽  
Zhuqing Yang ◽  
Tao Lei ◽  
Zichuan Ping ◽  
Guangchao Bai
Keyword(s):  
Blood Loss ◽  
Elderly Patients ◽  
Intertrochanteric Fracture ◽  
Aminocaproic Acid ◽  
Control Group ◽  
Hidden Blood Loss ◽  
Postoperative Drainage ◽  
Femoral Intertrochanteric Fracture ◽  
And Control ◽  
Experimental Group

Objective To determine the efficacy of aminocaproic acid on perioperative hidden blood loss (HBL) in elderly patients with femoral intertrochanteric fracture treated with proximal femoral nail anti-rotation (PFNA). Methods Seventy consecutively admitted elderly patients with femoral intertrochanteric fracture treated with PFNA between 1 May 2017 and 1 May 2018 were recruited. The patients were randomised into the experimental and control groups receiving 1 g aminocaproic acid in 200 mL saline and only 200 mL normal saline intravenously, respectively. The following factors were recorded: demographic characteristics, haemoglobin and haematocrit levels on preoperative day 1 and postoperative days 1 and 3, surgical blood loss, postoperative drainage, the rate and volume of transfusion, and complications. Results No significant differences were seen in surgical blood loss and postoperative drainage between the experimental and control groups, though total blood loss was greater in the control group. Visible blood loss and HBL were significantly lower in the experimental group than in the control group, and a lower rate and volume of transfusion were also recorded in the experimental group. Conclusion Aminocaproic acid significantly reduced perioperative HBL and volume and rate of transfusion in elderly patients with femoral intertrochanteric fracture receiving PFNA.

scholarly journals Effect and safety of topical application of tranexamic acid to reduce perioperative blood loss in elderly patients with intertrochanteric fracture undergoing PFNA

2020 ◽  
Author(s):  
Huiping Wei ◽  
Tianji Huang ◽  
Jianfeng He ◽  
Menghong Xia
Keyword(s):  
Blood Transfusion ◽  
Blood Loss ◽  
Elderly Patients ◽  
Tranexamic Acid ◽  
Topical Application ◽  
Intertrochanteric Fracture ◽  
Control Group ◽  
Drainage Volume ◽  
Hidden Blood Loss ◽  
Perioperative Blood Loss

Abstract Background: The specific method and dose of tranexamic acid (TXA) topically applied in intertrochanteric fracture have not been well established. The aim of this study is to investigate the efficacy and safety of TXA topically treated by our protocol in perioperative bleeding management for elderly patients with intertrochanteric fracture treated undergoing proximal femoral nail anti-rotation (PFNA). Methods: A retrospective comparative analysis was performed. Group TXA was comprised of 82 patients with topical use of TXA and group control was comprised of 82 patients without TXA during the procedure of PFNA. Intraoperative, total and hidden blood loss, drainage volume, postoperative blood transfusion volume and complications were compared between the two groups. Results: Intraoperative, total and hidden blood loss, and drainage volume were significantly lower in the TXA group than those in the control group (P=0.012, P<0.01, P<0.01, P=0.014, respectively). The volume and rate of blood transfusion in TXA group were significantly lower than those in the control group (P<0.01). There were no significant differences in complications between two groups (P>0.05). Conclusion: Topical application of TXA offers an effective and safe option in reducing perioperative blood loss and transfusion for elderly patients with intertrochanteric fractures undergoing PFNA.

scholarly journals Dynamic Analysis of Perioperative Hidden Blood Loss in Intertrochanteric Fractures

2019 ◽  
Vol 25 ◽  
pp. 107602961882327 ◽  
Author(s):  
Shuwei Tian ◽  
Hui Li ◽  
Meiyu Liu ◽  
Yanlong Zhang ◽  
Aqin Peng
Keyword(s):  
Blood Transfusion ◽  
Blood Loss ◽  
Intertrochanteric Fracture ◽  
Complete Blood Count ◽  
Dynamic Changes ◽  
Total Blood ◽  
Hidden Blood Loss ◽  
Postoperative Drainage ◽  
Males And Females ◽  
Perioperative Blood Transfusion

To analyze the dynamic variation in perioperative hidden blood loss in patients with intertrochanteric fracture. From January to December 2017, 79 patients with intertrochanteric fracture were treated with proximal femoral nail antirotation. Serial complete blood count assays were performed consecutively in the 3 days after admission, on the day of surgery, and 7 days postoperatively. Blood loss during surgery, postoperative drainage, and perioperative blood transfusion volumes were recorded. Dynamic changes in hemoglobin (Hb) prior to surgery were recorded and compared between males and females. Patients were divided into the no blood transfusion group, the 400-mL blood transfusion group, and the 800-mL blood transfusion group depending on the volume of perioperative blood transfusion. Total and hidden blood loss were separately calculated according to the Gross equation. Lowest mean Hb values occurred on day 2 after admission among men (104.8 g/L) and on day 3 after admission among women (98.6 g/L). The average Hb decrease was 11.4 g/L, 11.8 g/L, and 8.9 g/L in the no, 400-mL, and 800-mL blood transfusion groups, respectively. The lowest Hb value occurred on postoperative day 2. Hemoglobin increased on postoperative day 3 and stabilized by day 6. In the no blood transfusion group, the average total blood loss was 406.0 ± 255.6 mL, 628.3 ± 267.2 mL, and 759.7 ± 322.1 mL in the no blood transfusion, 400-mL blood transfusion, and 800-mL blood transfusion groups, respectively, and hidden blood loss was 326.0 ± 246.6 mL, 512.1 ± 247.3 mL, and 596.1 ± 306.9 mL, respectively. Perioperative hidden blood loss occurred prior to surgery for intertrochanteric fracture and ended on postoperative day 2.

scholarly journals Early intravenous tranexamic acid intervention reduces post-traumatic hidden blood loss in elderly patients with intertrochanteric fracture: a randomized controlled trial

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Huixu Ma ◽  
Hairuo Wang ◽  
Xiaotao Long ◽  
Zexiang Xu ◽  
Xiaohua Chen ◽  
...  
Keyword(s):  
Blood Loss ◽  
Elderly Patients ◽  
Tranexamic Acid ◽  
Venous Thrombosis ◽  
Intertrochanteric Fracture ◽  
Transfusion Rate ◽  
Intertrochanteric Fractures ◽  
Randomized Controlled ◽  
Hidden Blood Loss ◽  
Post Traumatic

Abstract Purpose Elderly patients with intertrochanteric fractures exhibit post-traumatic hidden blood loss (HBL). This study aimed to evaluate the efficacy and safety of reducing post-traumatic HBL via early intravenous (IV) tranexamic acid (TXA) intervention in elderly patients with intertrochanteric fracture. Methods A prospective randomized controlled study was conducted with 125 patients (age ≥ 65 years, injury time ≤ 6 h) who presented with intertrochanteric fracture from September 2018 and September 2019. Patients in the TXA group (n = 63) received 1 g of IV TXA at admission, whereas those in the normal saline (NS) group (n = 62) received an equal volume of saline. Hemoglobin (Hgb) and hematocrit (Hct) were recorded at post-traumatic admission (PTA) and on post-traumatic days (PTDs) 1–3. HBL was calculated using the Gross formula. Lower extremity venous ultrasound was performed to detect venous thrombosis. Results Hgb on PTDs 2 and 3 was statistically higher in the TXA group than in the NS group. Hct and HBL on PTDs 1–3 were significantly less in the TXA group compared to the NS group. Preoperative transfusion rate was significantly lower in the TXA group compared with the NS group. There was no difference between the two groups with regard to the rates of complications. Conclusion Early IV TXA intervention could reduce post-traumatic HBL and pre-operative transfusion rate in elderly patients with intertrochanteric fractures without increasing the risk of venous thrombosis.

scholarly journals Early intravenous tranexamic acid intervention reduces post-traumatic hidden blood loss in elderly patients with intertrochanteric fracture: a randomized controlled trial

2020 ◽  
Author(s):  
Hui Xu Ma ◽  
Hairuo Wang ◽  
Xiaotao Long ◽  
Zexiang Xu ◽  
Xiaohua Chen ◽  
...  
Keyword(s):  
Blood Loss ◽  
Elderly Patients ◽  
Tranexamic Acid ◽  
Venous Thrombosis ◽  
Intertrochanteric Fracture ◽  
Transfusion Rate ◽  
Intertrochanteric Fractures ◽  
Randomized Controlled ◽  
Hidden Blood Loss ◽  
Post Traumatic

Abstract Purpose Elderly patients with intertrochanteric fractures exhibit post-traumatic hidden blood loss (HBL). This study aimed to evaluate the efficacy and safety of reducing post-traumatic HBL via early intravenous (IV) tranexamic acid (TXA) intervention in elderly patients with intertrochanteric fracture.Methods A prospective, randomized, controlled study was conducted with 125 patients (age ≥65 years, injury time ≤6 h) who presented with intertrochanteric fracture from September 2018 and September 2019. Patients in the TXA group (n=63) received 1 g of IV TXA at admission, whereas those in the normal saline (NS) group (n=62) received an equal volume of saline. Hemoglobin (Hgb) and hematocrit (Hct) were recorded at post-traumatic admission (PTA) and on post-traumatic day (PTD) 1–3. HBL was calculated using the Gross formula. Lower extremity venous ultrasound was performed to detect venous thrombosis.Results Hgb on PTD 2 and 3 were statistically higher in the TXA group than in the NS group. Hct and HBL on PTDs 1-3 were significantly less in the TXA group than in the NS group. Preoperative transfusion rate was significantly lower in the TXA group than in the NS group. There was no difference between the two groups with regard to the rates of complications.Conclusion Early IV TXA intervention could reduces post-traumatic HBL and pre-operative transfusion rate in elderly patients with intertrochanteric fractures without increasing the risk of venous thrombosis.

scholarly journals Early intravenous tranexamic acid intervention reduces post-traumatic hidden blood loss in elderly patients with intertrochanteric fracture: a randomized controlled trial

2020 ◽  
Author(s):  
Hui Xu Ma ◽  
Hairuo Wang ◽  
Xiaotao Long ◽  
Zexiang Xu ◽  
Xiaohua Chen ◽  
...  
Keyword(s):  
Blood Loss ◽  
Elderly Patients ◽  
Tranexamic Acid ◽  
Venous Thrombosis ◽  
Intertrochanteric Fracture ◽  
Transfusion Rate ◽  
Intertrochanteric Fractures ◽  
Randomized Controlled ◽  
Hidden Blood Loss ◽  
Post Traumatic

Abstract Purpose Elderly patients with intertrochanteric fractures exhibit post-traumatic hidden blood loss (HBL). This study aimed to evaluate the efficacy and safety of reducing post-traumatic HBL via early intravenous (IV) tranexamic acid (TXA) intervention in elderly patients with intertrochanteric fracture.Methods A prospective, randomized, controlled study was conducted with 125 patients (age ≥65 years, injury time ≤6 h) who presented with intertrochanteric fracture from September 2018 and September 2019. Patients in the TXA group (n=63) received 1 g of IV TXA at admission, whereas those in the normal saline (NS) group (n=62) received an equal volume of saline. Hemoglobin (Hgb) and hematocrit (Hct) were recorded at post-traumatic admission (PTA) and on post-traumatic day (PTD) 1–3. HBL was calculated using the Gross formula. Lower extremity venous ultrasound was performed to detect venous thrombosis.Results Hgb on PTD 2 and 3 were statistically higher in the TXA group than in the NS group. Hct and HBL on PTDs 1-3 were significantly less in the TXA group compared to the NS group. Preoperative transfusion rate was significantly lower in the TXA group compared with the NS group. There was no difference between the two groups with regard to the rates of complications.Conclusion Early IV TXA intervention could reduces post-traumatic HBL and pre-operative transfusion rate in elderly patients with intertrochanteric fractures without increasing the risk of venous thrombosis.

scholarly journals Early intravenous tranexamic acid intervention reduces post-traumatic hidden blood loss in elderly patients with intertrochanteric fracture: a randomized controlled trial

2020 ◽  
Author(s):  
Hui Xu Ma ◽  
Hairuo Wang ◽  
Xiaotao Long ◽  
Zexiang Xu ◽  
Xiaohua Chen ◽  
...  
Keyword(s):  
Blood Loss ◽  
Elderly Patients ◽  
Tranexamic Acid ◽  
Venous Thrombosis ◽  
Intertrochanteric Fracture ◽  
Transfusion Rate ◽  
Intertrochanteric Fractures ◽  
Randomized Controlled ◽  
Hidden Blood Loss ◽  
Post Traumatic

Abstract Purpose Elderly patients with intertrochanteric fractures exhibit post-traumatic hidden blood loss (HBL). This study aimed to evaluate the efficacy and safety of reducing post-traumatic HBL via early intravenous (IV) tranexamic acid (TXA) intervention in elderly patients with intertrochanteric fracture.Methods A prospective, randomized, controlled study was conducted with 125 patients (age ≥65 years, injury time ≤6 h) who presented with intertrochanteric fracture from September 2018 and September 2019. Patients in the TXA group (n=63) received 1 g of IV TXA at admission, whereas those in the normal saline (NS) group (n=62) received an equal volume of saline. Hemoglobin (Hgb) and hematocrit (Hct) were recorded at post-traumatic admission (PTA) and on post-traumatic day (PTD) 1–3. HBL was calculated using the Gross formula. Lower extremity venous ultrasound was performed to detect venous thrombosis.Results Hgb on PTD 2 and 3 were statistically higher in the TXA group than in the NS group. Hct and HBL on PTDs 1-3 were significantly less in the TXA group compared to the NS group. Preoperative transfusion rate was significantly lower in the TXA group compared with the NS group. There was no difference between the two groups with regard to the rates of complications.Conclusion Early IV TXA intervention could reduces post-traumatic HBL and pre-operative transfusion rate in elderly patients with intertrochanteric fractures without increasing the risk of venous thrombosis.

scholarly journals Local administration of epsilon-aminocaproic acid reduces post-operative blood loss from surgery for closed, Sanders III–IV calcaneal fractures

2022 ◽  
Author(s):  
Lang Zhong ◽  
Yangbo Xu ◽  
Yongcai Wang ◽  
Yu Liu ◽  
Qiu Huang
Keyword(s):  
Blood Loss ◽  
Aminocaproic Acid ◽  
Wound Complications ◽  
Local Administration ◽  
Control Group ◽  
Calcaneal Fractures ◽  
Operative Blood Loss ◽  
Significant Difference ◽  
Operative Drainage ◽  
And Control

Abstract Purpose To investigate whether local administration of epsilon-aminocaproic acid (EACA) is effective and safe in reducing the post-operative blood loss in surgery for Sanders III–IV calcaneal fractures. Methods Patients with Sanders III–IV calcaneal fractures who were hospitalized in our hospital from January 2016 to February 2021 and underwent open reduction internal fixation (ORIF) via lateral approach with an L-shaped incision were included in the current study. Eighty five patients were randomly divided into two groups, EACA group (43) and control group (42). Twenty milliliters of 5% EACA solution or normal saline was perfused into the incision of patients in EACA group and control group, respectively. The volume of post-operative drainage was investigated as the primary outcome. Post-operative blood test, coagulation test, and wound complications were analyzed as the secondary outcomes. Results The volume of post-operative drainage at 24 and 48 h was 164.8 ± 51.4 ml, 18.9 ± 3.8 ml for patients in EACA group, and 373.0 ± 88.1 ml, 21.2 ± 4.4 ml for patients in the control group, respectively. EACA greatly reduced the post-operative blood loss compared to the control (normal saline). The difference between the two groups was statistically significant. No statistically significant difference was found between EACA group and control group with regard to the pre-operative, baseline characteristics. Post-operative blood test results demonstrated that haemoglobin and hematocrit were significantly higher in EACA compared to those of control group. No significant difference was found between EACA group and control group in terms of the platelet counts, prothrombin time (P.T.), activated partial prothrombin time (APTT), and wound complications. Conclusion Local administration of EACA is effective in post-operative blood loss reduction in ORIF surgeries for Sanders III–IV types of calcaneal fractures without increasing the incidence of periwound complication.

scholarly journals Intramedullary hemostasis further reduces postoperative anemia in patients over 70 years old undergoing total hip arthroplasty

2020 ◽  
Vol 28 (3) ◽  
pp. 230949902096562
Author(s):  
Kaying Tang ◽  
Yahong Wu ◽  
Yuan Mu ◽  
Ruidong Li ◽  
Mao Nie ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Blood Loss ◽  
Hip Arthroplasty ◽  
Control Group ◽  
Total Blood ◽  
Total Hip ◽  
Hidden Blood Loss ◽  
Elder Patients ◽  
Moderate Anemia ◽  
Experimental Group

Purpose: Postoperative anemia has been a threat to total hip arthroplasty patients. We introduced a novel medullary cavity hemostasis (MCH) technique and combined it with tranexamic acid (TXA) to prevent postoperative anemia in elder patients. This trial was conducted to evaluate the effectiveness and safety of this technique. Methods: In this retrospective consecutive study, each group has 88 patients who were all over 70 years old. In the control group, patients were given TXA. In the experimental group, the MCH technique and same TXA application were used. Results: The average of total blood loss, drainage volume, and hidden blood loss were significantly less in the experimental group. The postoperative hemoglobin (Hb) level was significantly higher in the experimental group (100.6 g/dL) than it is in the control group (81.4 g/dL). None of the patient has shown signs of prosthesis subsidence, periprosthetical osteolysis, or stem loosening during follow-ups in the average follow-up time of 3 years. Conclusion: We discovered that application of TXA alone is not sufficient to prevent postoperative moderate anemia in patients over 70 years old. Combination of TXA and MCH is an effective and safe way to alleviate the severity of postoperative anemia.

scholarly journals Quercetine influence on the resological properties of blood for elderly patients with metabolic syndrome

2019 ◽  
Vol 26 (3) ◽  
pp. 71-77
Author(s):  
O. V. Korkushko ◽  
S. S. Naskalova ◽  
I. A. Antonyuk-Shcheglova ◽  
G. V. Duzhak ◽  
O. V. Bondarenko ◽  
...  
Keyword(s):  
Metabolic Syndrome ◽  
Platelet Aggregation ◽  
Elderly Patients ◽  
Blood Viscosity ◽  
Control Group ◽  
Cholesterol Levels ◽  
Before And After ◽  
And Control ◽  
Experimental Group ◽  
Lipid Spectrum

The aim – to study the effects of quercetin on the functional status of platelets and blood viscosity in elderly patients with metabolic syndrome (MS). Materials and methods. Fifty patients with MS at the age of 60–75 years, who were equally distributed into the experimental and control groups, were examined. Patients of the experimental group received quercetin for 3 months («Quertin», PJSC SIC «Borshchahivskiy CPP», Ukraine) 80 mg 3 times a day. The control group received placebo for the same period of time. Before and after the treatment, MS criteria, platelet aggregation ability, blood viscosity and serum lipid levels were assessed. Results and discussion. After quercetin course, the rheological blood properties improved, that is its viscosity, spontaneous and induced platelet aggregation decreased. A statistically significant decrease in serum total cholesterol and LDL cholesterol levels was noted. Correlation analysis showed that an improvement in blood viscosity occurred due to favourable changes in the lipid spectrum and a decrease in the aggregation ability of blood cells. Conclusions. The obtained results indicate that in elderly patients with metabolic syndrome a course (within 3 months) use of quercetin reduces manifestations of dyslipidemia, increases spontaneous and induced platelet aggregation, contributes to an increase in the erythrocyte deformability index, which together lead to the decrease of blood viscosity, as one of the risk factors for the development of complications in metabolic syndrome.

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