scholarly journals Perioperative blood loss in total hip and knee arthroplasty: Outcomes associated with intravenous tranexamic acid use in an academic medical center

2016 ◽  
Vol 4 ◽  
pp. 205031211663702 ◽  
Author(s):  
Craig A Hogan ◽  
Larry K Golightly ◽  
Suzanne Phong ◽  
Michael R Dayton ◽  
Clark Lyda ◽  
...  
Keyword(s):  
Treatment Group ◽  
Blood Loss ◽  
Confidence Interval ◽  
Tranexamic Acid ◽  
Knee Arthroplasty ◽  
Control Group ◽  
Control Groups ◽  
Joint Replacement Surgery ◽  
Replacement Surgery ◽  
And Control

Objectives: Clinical trials have reported decreased blood loss with the use of tranexamic acid during joint reconstruction. The purpose of this study was to assess the individual practice implications of tranexamic acid use in joint replacement surgery. Methods: Health records of adults undergoing total knee arthroplasty and total hip arthroplasty over a 12-month period were retrospectively reviewed. The treatment group comprised patients who received intravenous tranexamic acid perioperatively. The control group comprised patients who did not receive tranexamic acid. Results: Patients in the treatment group (n = 64) and the control group (n = 99) were well matched for demographics, orthopedic diagnosis, and comorbidities. In-hospital postsurgical mean decreases in hemoglobin concentrations were −4.05 g/dL and −4.94 g/dL in the treatment and control groups, respectively (p < 0.001). Postsurgical mean decreases in hematocrit levels were −11.2% and −14.2% in the treatment and control groups, respectively (p < 0.001). Three patients in the treatment group (5%) and 21 patients in the control group (21%) received red blood cell transfusions (p = 0.006). As compared to control, the relative risk of transfusion in the treatment group was 0.23 (95% confidence interval = 0.07–0.76) and the number needed to treat to avoid one transfusion was 7.0 (95% confidence interval = 3.8–14.4). No evidence of thromboembolism or other serious complications were observed in either group. Conclusions: In patients undergoing joint replacement surgery, perioperative administration of tranexamic acid was associated with diminished blood loss and lesser resource utilization.

scholarly journals The Efficacy of Intravenous Tranexamic Acid in Reduction of Blood Loss in Women at High Risk of Postpartum Hemorrhage

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
K M Diab ◽  
R M Mohamed ◽  
A G Abdelhay
Keyword(s):  
Blood Loss ◽  
Cesarean Section ◽  
Tranexamic Acid ◽  
Maternal Mortality ◽  
Vaginal Delivery ◽  
Control Group ◽  
Study Group ◽  
Control Groups ◽  
Significant Difference ◽  
And Control

Abstract Background Postpartum hemorrhage (PPH) is the leading cause of maternal mortality. All women who carry a pregnancy beyond 20 weeks’ gestation are at risk for PPH and its sequelae. Although maternal mortality rates have declined greatly in the developed world, PPH remains a leading cause of maternal mortality elsewhere. Aim of the Work To assess the efficacy and safety intravenous tranexamic acid in reduction of amount of blood loss in high risk women who deliver by cesarean section or vaginal delivery in postpartum period. Patients and Methods This prospective double blind randomized controlled clinical trial study was conducted on 200 patients planned for LSCS or vaginal delivery at Gestational Age ≥ 34 Weeks at Ain Shams University Maternity Hospital. Recruitment of data begun once the protocol was approved by research and ethical committee of the department of obstetrics and gynecology. Results No significant difference between Study and Control groups as regards age (p = 0.508), no significant difference between Study and Control groups as regards Gestational age (p = 0.447),total blood loss (p &lt; 0.001) was significantly lower in study group than control group, Vaginal pads in the 1st 24 hours post-partum was significantly less soaked in study group than control group (p &lt; 0.001). no significant difference between Study and Control groups as regards Preoperative Hemoglobin, Postoperative Hemoglobin was significantly higher in study group than control group (p &lt; 0.001), Reduction in Hemoglobin was significantly less in study group than control group (p &lt; 0.001), no significant difference between Study and Control groups as regards Preoperative Hematocrite, Postoperative Hematocrit was significantly higher in study group than control group (p &lt; 0.001), Reduction in Hematocrite was significantly less in study group than control group (p &lt; 0.001).Need to iron replacement or blood transfusion was significantly less frequent in study group than control group (p = 0.24). Conclusion The use of tranexamic acid prior to cesarean section or vaginal delivery is effective as a prophylaxis against post-partum hemorrhage as shown by the results of this study. It can significantly reduce blood loss during and after cesarean section or vaginal delivery.

scholarly journals Android-Based Education toward the Role of Postpartum Primipara Mothers in Fulfilling the Independent Perinium Care

2021 ◽  
Vol 1 (2) ◽  
pp. 55-67
Author(s):  
Werna Nontji ◽  
Dwi Kartika Sari ◽  
Sitti Maria Ulfa ◽  
Syafruddin Syarif ◽  
Inez Vravty Lestari ◽  
...  
Keyword(s):  
Treatment Group ◽  
Intervention Group ◽  
Wilcoxon Test ◽  
Control Group ◽  
P Value ◽  
Control Groups ◽  
Post Test ◽  
Android App ◽  
And Control ◽  
Perineal Care

Background: Educating mothers during their postpartum period could potentially help them to overcome some important phases after giving birth. The process of education is evaluated based on the mothers’ knowledge about their independent self-care. Independency is an activity that is started individually and is done based on self-capability. The independency in the postpartum care is not only important to decrease the mother’s mortality and morbidity rate, but it is also crucial to strengthen and improve the post-partum mother’s healthy behavior during the perineal care. Providing education using Android-based application called BUBI Care could be potential to facilitate a more dynamic transfer of knowledge to the postpartum mothers.Aims: To analyze the knowledge, skills, and independence of primipara postpartum mothers in independent perineal care before and after accessing BUBI Care app. Research Method: employing quasi experimental research with pre-test and post-test design with control group design. The sample for this research were 19 pregnant mothers TM III (pregnancy age of ? 38 weeks) on each group. The treatment group was educated using BUBI Care Android app that was conducted at one of Public Health Center. The control group was educated without BUBI Care that was conducted at a Midwife Practice Clinic. The research was conducted on September to October 2020. Study Result: According to the Wilcoxon test, there was a difference in the pre-test knowledge of the treatment and control groups with the similar median of 53 and p-value of 0.666, the treatment group showed their scores improved to 80 on the post-test while the control group stayed at 53 with the p-value of 0.000. It means that BUBI Care app education influences the post-test. On the other hand, the perineal care skill saw a difference between the intervention and control groups. The intervention group had a mean of 70.05 and 56.68 for the control group with the p-value of 0.002 which means that there was an influence from the BUBI Care app education. Additionally, Mann Whitney test showed that the intervention group had a mean score of 78.95, but the control group only had 49.26, the total difference between the two are 29.69 with the p-value of 0.000. It can be concluded that there is a significance in difference in the independency rate from the provision of BUBI Care Android app education.Conclusion:  there is a significance effect on the intervention group in terms of Android based usage.

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.

Reduction in Accumulation of Plaque, Stain, and Calculus in Dogs by Dietary Means

1995 ◽  
Vol 12 (4) ◽  
pp. 161-163 ◽  
Author(s):  
Lyn Jensen ◽  
Ellen Logan ◽  
Oliver Finney ◽  
Stephen Lowry ◽  
Martyn Smith ◽  
...  
Keyword(s):  
Treatment Group ◽  
Plaque Index ◽  
Control Group ◽  
Control Groups ◽  
Dog Food ◽  
Control Food ◽  
And Control ◽  
All Treatment

We conducted 215 evaluations for plaque, stain, and calculus in 120 dogs at two research sites. Dogs were balanced in groups of five according to baseline plaque index scores; groups were randomly assigned to treatment or control dietary regimens. Dental cleanings were done on Day 0. Dogs in the treatment group were fed a food formulated to reduce accumulation of plaque, stain, and calculus. Control group dogs were fed a commercially available dry dog food. No other foods, treats, or snacks were given to either group. We graded 22 teeth for plaque accumulation on Day 7 and for stain and calculus accumulation on Day 21. Six trials were conducted and the results reported as a combined mean for all treatment and control groups. Dogs fed the treatment food had significantly less plaque, stain, and calculus accumulation (p=0.001) than dogs fed the control food. Plaque, stain, and calculus accumulation can be reduced by dietary means.

scholarly journals Application of thromboelastography to evaluate the effect of different routes administration of tranexamic acid on coagulation function in total hip arthroplasty

2019 ◽  
Vol 14 (1) ◽  
Author(s):  
Xingming Xu ◽  
Jiang Jiang ◽  
Wei Liu ◽  
Xiaofeng Li ◽  
Huading Lu
Keyword(s):  
Total Hip Arthroplasty ◽  
Blood Loss ◽  
Tranexamic Acid ◽  
Hip Arthroplasty ◽  
Perioperative Complications ◽  
Control Groups ◽  
Total Blood ◽  
Total Hip ◽  
Coagulation Function ◽  
And Control

Abstract Background Tranexamic acid (TXA) is widely used to reduce blood loss and transfusion rates in total hip arthroplasty(THA). Thromboelastography, which can monitor coagulation changes from clotting to fibrinolysis dynamically. In this study, thromboelastography was used to assess the dynamic changes in the coagulation of patients who underwent THA with the administration of TXA. Methods This randomized controlled trial consisted of 207 consecutive patients who underwent primary total hip arthroplasty. Patients were randomized into three groups: topical-TXA group received a topical application of TXA, IV-TXA group received an intravenous injection of TXA, and control group. Thromboelastography was performed 1 day before surgery and first, fourth, seventh days after surgery. The primary outcomes were thromboelastography parameters, the rates of deep vein thrombosis(DVT), and pulmonary embolism(PE). Secondary outcomes included perioperative blood loss, transfusion rates, and other perioperative complications. Results The mean calculated total blood loss in the Topical-TXA group were 832.7 ± 279.84 ml and 834.8 ± 322.94 ml in the IV-TXA group, which were significantly reduced (p < 0.05) compared with control groups at 1093.3 ± 379.7 ml. There were no significant differences between topical-TXA and IV-TXA groups in total blood loss or transfusion rates. K and R have reached a nadir from preoperative levels to 4th day postoperatively and then began to increase.α angle and CI peaked from preoperative levels to the fourth day postoperatively and then began to decline.IV-TXA significantly (p < 0.05) promoted coagulation levels compared with topical-TXA and control groups in the early postoperative period. Almost no significant differences were observed between topical-TXA and control groups in thromboelastography parameters.No significant differences were observed in the incidence of thromboembolic complications and other perioperative complications. Conclusions The topical administration of TXA had the same hemostatic effect as intravenous injection tranexamic acid. Coagulation function peaked on 4th day postoperatively and then began to decline. IV-TXA was more enhanced coagulation functions compared with topical-TXA.

scholarly journals Effects of intravenous tranexamic acid on ovarian reserve and intra-operative blood loss during laparoscopic cystectomy of endometriotic cyst: a pilot randomized controlled trial

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Prangthip Akkaranurakkul ◽  
Srithean Lertvikool ◽  
Woradej Hongsakorn ◽  
Orawin Vallibhakara ◽  
Siriluk Tantanavipas ◽  
...  
Keyword(s):  
Blood Loss ◽  
Tranexamic Acid ◽  
Ovarian Reserve ◽  
Controlled Trial ◽  
Mean Difference ◽  
Control Groups ◽  
Operative Blood Loss ◽  
Post Surgery ◽  
Laparoscopic Cystectomy ◽  
And Control

Abstract Background Strategies to preserve ovarian function after ovarian endometriotic cyst removal have been reported in many studies; however, no study has evaluated tranexamic acid administration during surgery. Objective To evaluate feasibility of conducting a definitive trial and assessing the potential efficacy of tranexamic acid on ovarian reserve and intra-operative blood loss by comparing mean differences in anti-Müllerian hormone (AMH) levels following laparoscopic ovarian cystectomy between tranexamic acid and control groups. Materials and methods A parallel two-arm pilot trial was conducted with 40 participants with endometriotic cysts who underwent laparoscopic ovarian cystectomy. They were randomized 1:1 to either 1 g tranexamic acid (TXA) or no TXA (n = 20 per group). TXA was administered to the participants immediately after induction of general anesthesia and intubation. The primary outcome was the feasibility of conducting a definitive trial in terms of design and procedures (such as recruitment rate, retention, safety of intravenous 1 gm of TXA, sample size verification) and assess the efficacy of TXA on the ovarian reserve and intra-operative blood loss by comparing mean difference of AMH levels between TXA and control groups at pre- and 3 months post-surgery. Results The recruitment and successful completion rates were 95% and 100%. Baseline characteristics were similar in the two groups. The mean difference of serum AMH levels (pre- and 3 months post-surgery) between the TXA and control groups was not significantly different. When performing a subgroup analysis, the mean difference of AMH levels (pre- and 3 months post-surgery) seemed to be higher in the bilateral than in the unilateral ovarian cyst group but not significantly different. Operating time was significantly longer in bilateral than in unilateral cysts. No post-operative complications or adverse effects were found. Conclusion The full randomized controlled trial for evaluating effects of TXA administration during laparoscopic cystectomy for endometrioma on ovarian reserve was shown to be feasible. Several modifications should be added for improving feasibility, for example, increasing the TXA dose, modifying TXA administration, focusing on either patients with unilateral or bilateral ovarian cysts, and exploring other outcome measures, e.g., surgeons’ satisfaction. Trial registration Thai Clinical Trials Registry, TCTR20190424002, Registered 24 April 2019.

533 Establishment and Effects of a Method for Wound Repair in Patients with Extensive Deep Burns Using Fresh Skin Allografts and Autologous Micrograft

2020 ◽  
Vol 41 (Supplement_1) ◽  
pp. S104-S104
Author(s):  
Chuanan Shen ◽  
Tianjun Sun ◽  
Huping Deng ◽  
Yuezeng Niu
Keyword(s):  
Treatment Group ◽  
Wound Repair ◽  
Coverage Rate ◽  
Control Group ◽  
Control Groups ◽  
Skin Allograft ◽  
Wound Coverage ◽  
And Control ◽  
Scar Hypertrophy

Abstract Introduction This study was to establish a method for wound repair in patients with extensive deep burns using fresh allogeneic scalp combined with autologous micrograft. Methods Two patients with burn injuries involving 90% (3rd degree, 70%) and 97% (3rd degree, 85%) total body surface area (TBSA) respectively were treated with fresh scalp allografts donated by 32 males aged (31.5 ± 8.2) years or autologous micrografting. The bilateral limbs with third-degree burns were selected as treatment and control groups. Wounds in the treatment group were treated with fresh allogeneic scalp and autologous micrograft, while wound in the control group received MEEK grafting. Preoperatively, the surgical area on the extremities was calculated to estimate the necessary amount of allogeneic scalp and MEEK grafts. Fresh scalps (0.30 - 0.35 mm) were harvested from each donor to prepare a larger piece of skin allograft. Autologous micrografts were transported onto the epidermis of the skin allograft. The treatment and control group received grafting according to our protocol. The donors received follow-up visits after 3 months to see if there is alopecia and scar hypertrophy. The wound coverage rate was observed in both treatment and control groups on postoperative weeks 2, 3, 4 and 5. Results The donor sites in all allogeneic skin donors healed within 10 days postoperatively. The scalp recovered well without any alopecia or scar hypertrophy during the follow-up visits. The wound coverage rate of the treatment group was approximate to or higher than that of the control group. Conclusions Considering that allogeneic skin is scarce and expensive and the patient’s relatives are willing to help save the patient’s life by donating the scalp, this method may be a feasible clinical treatment option. Applicability of Research to Practice This study is a clinical study which is highly applicable in practice.

scholarly journals Evaluation of the Impacts of a Phone Warning and Advising System for Individuals Vulnerable to Smog. Evidence from a Randomized Controlled Trial Study in Canada

2019 ◽  
Vol 16 (10) ◽  
pp. 1817 ◽  
Author(s):  
Kaddour Mehiriz ◽  
Pierre Gosselin
Keyword(s):  
Air Pollution ◽  
Treatment Group ◽  
Controlled Trial ◽  
Vulnerable Groups ◽  
Control Group ◽  
Warning Systems ◽  
Protective Behaviors ◽  
Control Groups ◽  
Research Stream ◽  
And Control

Smog warning systems are components of adaptation strategies that are adopted by governments around the world to protect their citizens from extreme episodes of air pollution. As part of a growing research stream on the effectiveness of these systems, this article presents the results of a study on the impacts of an automated phone warning and advising system for individuals vulnerable to air pollution. A sample of 1328 individuals were recruited and randomly assigned to treatment and control groups. The treatment group received smog warning while the control group did not. Data were collected via three phone surveys, two before and one after issuing the smog warning. The comparison between treatment and control groups indicates that exposure to a smog warning improved information on the occurrence of smog episodes (n = 484, OR = 5.58, p = 0.00), and knowledge on protective behaviors. Furthermore, members of treatment group were more likely to avoid exposure to smog episodes by spending more time inside with the windows closed than usual (n = 474, OR = 2.03, p = 0.00). Members of treatment group who take medication in the form of aerosol pumps also kept these devices on themselves more frequently than those of control group (n= 109, OR = 2.15, p = 0.03). The system however had no discernible effects on the awareness of air pollution risks, reduction of health symptoms related to smog and the use of health system services. The absence of health benefits could be related to the lower actual exposure to air pollution of such vulnerable groups during winter.

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