scholarly journals Intravenous Tranexamic Acid Decreases Blood Transfusions and Blood Loss for Patients with Surgically Treated Hip Fractures

2021 ◽  
Vol 12 ◽  
pp. 215145932110636
Author(s):  
Phuong Anh N Huynh ◽  
Megan Miller ◽  
Ryan Will
Keyword(s):  
Blood Loss ◽  
Tranexamic Acid ◽  
Risk Reduction ◽  
Hip Fractures ◽  
Absolute Risk ◽  
Blood Transfusions ◽  
Total Blood ◽  
Allogenic Blood ◽  
Operative Care ◽  
Decrease Blood Loss

Introduction Tranexamic acid can decrease blood loss related to surgery and trauma. The primary objective of this study is to examine if the use of a single dose of peri-operative TXA significantly decreases the rate of allogenic blood transfusions in the setting of operative care of hip fractures. Secondary objectives included examining if total blood loss was decreased by TXA in operative hip fractures as well as examining the safety of TXA by measuring the rates venous thromboembolism (VTE). Methods Retrospective chart review of 505 patients who were operatively treated for hip fractures at a single facility was performed. In a non-randomized fashion, 307 patients received TXA and 198 patients did not. Patients received 1 gram of TXA prior to incision. Blood transfusion was the primary end point. Blood loss was calculated using the hemoglobin balance method. Chart was reviewed for VTE events during hospitalization. Results 505 patients were analyzed. The use of single perioperative dose of TXA in the surgical management of hip fracture resulted in absolute risk reduction of transfusion of 7.7% and relative risk reduction of transfusion by 29%. This was statistically significant with P =.04. Patients who received TXA on average lost 235 ml less blood compared to those who did not receive TXA ( P <.0001). No increase in VTE events were found in either group during hospitalization. Conclusion This study supports the use of TXA is decrease blood loss and transfusion rates in patients with hip fractures. TXA can be used routinely to decrease complications in this usually fragile population.

scholarly journals A randomized, non-crossover, parallel-group analysis of tranexamic acid in minimizing blood loss and transfusions in total knee arthroplasty

2021 ◽  
Vol 0 ◽  
pp. 1-4
Author(s):  
Nikhil Mudgalkar
Keyword(s):  
Total Knee Arthroplasty ◽  
Blood Loss ◽  
Tranexamic Acid ◽  
Knee Arthroplasty ◽  
Acid Group ◽  
Total Blood Loss ◽  
Blood Transfusions ◽  
Total Blood ◽  
Parallel Group ◽  
Total Knee

Objectives: Total knee arthroplasty is associated with significant blood loss, necessitating blood transfusions. Due to the obvious risks and costs of allogeneic blood transfusions, techniques to minimize blood loss in surgery are needed. The objective of this study was to assess the efficacy of tranexamic acid treatment in reducing blood loss and blood transfusion requirements during total knee arthroplasty. Materials and Methods: A prospective, randomized, double-blind, parallel-group, non-crossover trial was carried out in Prathima Hospital, Karimnagar. The trial involved 28 ASA I and II patients undergoing unilateral knee arthroplasty, 14 in each of the control and study groups. In the study group, a 10 mg/kg bolus of tranexamic acid was administered slowly IV 30 min before tourniquet deflation, followed by a 1 mg/kg/hr infusion for 12 h, compared to the standard medical treatment in the control group. Total blood loss during and after surgery was compared between the two classes. We also compared the hemoglobin drop after surgery, the number of people who needed blood transfusions, and the number of units needed between the two classes. Any complications were also reported. Results: Total blood loss in the tranexamic acid group was 543.3 ± 184.85 versus 685.83 ± 176.74, a statistically significant difference (P < 0.05). Intraoperative blood loss was comparable, but post-operative blood loss was significantly lower in the tranexamic acid group (389.16 ± 174 ml vs. 514.36 ± 143.89 ml), indicating that it was statistically significant (P < 0.05). There were no complications reported from any of the groups. Conclusion: Tranexamic acid is an effective strategy for minimizing overall blood loss and blood transfusions in patients undergoing total knee arthroplasty.

scholarly journals A COMPARATIVE STUDY OF ASSESSMENT OF ROLE OF TRANEXAMIC ACID IN CONTROLLING BLOOD LOSS IN ORTHOPAEDIC SURGERIES: A RANDOMISED CONTROL TRIAL.

2020 ◽  
Vol 4 (4) ◽  
Author(s):  
Deepak Kumar ◽  
Santosh Kumar
Keyword(s):  
Blood Loss ◽  
Tranexamic Acid ◽  
Total Blood Loss ◽  
Randomised Control Trial ◽  
Blood Transfusions ◽  
Total Blood ◽  
Post Operative Period ◽  
Group A ◽  
Group B

Aim: to study the role of Tranexamic Acid in Controlling Blood Loss In orthopaedic surgeries. Material & Methods: 50 patients were included in the study during the study period. Patients were randomly allotted to 2 groups of equal participants. The first group (Group A) received Tranexamic Acid. The second group (Group B) was given Normal saline as placebo. The Total Blood Loss ( intra operative + post operative ) and Fall in Haemoglobin levels were measured post-operatively at 24 and 72 hrs of post-operative period. Result: The group A had showed significantly reduced total blood loss and fall in Haemoglobin, thus, requiring fewer blood transfusions. No complications were observed. Conclusions: the present investigation concluded that Tranexamic acid can be effective in reducing blood loss and subsequent fall in haemoglobin. Keywords: Tranexamic acid, Bleeding, Major Orthopaedic surgeries.

TO EVALUATE THE EFFECT OF PROPHYLACTIC USE OF TRENEXAMIC ACID ON BLEEDING DURING ELECTIVE LSCS. A STUDY CONDUCTED IN TERTIARY CARE HOSPITAL OF CENTRAL INDIA.

2021 ◽  
pp. 223-225
Author(s):  
Dhara Singh ◽  
Sujata bhargava
Keyword(s):  
Blood Loss ◽  
Tranexamic Acid ◽  
Tertiary Care ◽  
Alternative Methods ◽  
World Health ◽  
Study Cohort ◽  
Care Hospital ◽  
Total Blood ◽  
And Control ◽  
The Impact

Background: Recent guidelines of the World Health Organization (WHO) indicated administering tranexamic acid (TXA) in order to treat postpartum bleeding (PPH). Therefore, nding low-cost and lowrisk alternative methods to control obstetric bleeding is of great importance. The present study aimed to evaluate the prophylactic effect of TXA on bleeding during and after the LSCS. In addition, it was attempted to explore the impact of TXA as a safe and inexpensive method for decreasing bleeding during and after CS so that to decrease the hazard of blood transfusion or hysterectomy in these patients. Material and Methods: This prospective study conducted on 100 women in Department of Obstetrics &gynecolgy for one year period. They were divided in two groups: Cases: (n=50; women receiving prophylactic Tranexamic Acid) and Control: (n=50; women receiving saline). Estimated the amount of blood loss during surgery. The amount of blood loss during surgery were calculated Estimation of weight of dry towels and mops before autoclaving is noted. Results: Most common age group among Cases and Control was 26-30 years .%. Mean age among cases group (26.69±7.51 years) was signicantly lesser compared to control study cohort (29.75±7.72). Post operativehemoglobin level was signicantly higher among Case (11.26±12.03) as compared to Control (8.56±1.01). Comparing post operative complications revealedno signicant changes. Use of topical hemostatics was higher among the control (77%) as compared to Cases (57%). Conclusion: Prophylactic treatment with TXA in relation to elective LSCS reduces the overall total blood loss, and the risk of reoperations owing to postoperative hemorrhage as revealed by higher hemoglobin level among cases.

scholarly journals Tranexamic acid reduces blood loss and blood transfusions in primary total hip arthroplastyA prospective randomized double-blind study in 40 patients

2003 ◽  
Vol 74 (6) ◽  
pp. 665-669 ◽  
Author(s):  
Henrik Husted ◽  
Lars Blønd ◽  
Stig Sonne-Holm ◽  
Gitte Holm ◽  
Tine Jacobsen ◽  
...  
Keyword(s):  
Blood Loss ◽  
Tranexamic Acid ◽  
Blind Study ◽  
Blood Transfusions ◽  
Double Blind Study ◽  
Double Blind ◽  
Total Hip

scholarly journals Uterine Balloon Tamponade in Combination with Topical Administration of Tranexamic Acid for Management of Postpartum Hemorrhage

2015 ◽  
Vol 2015 ◽  
pp. 1-4 ◽  
Author(s):  
Masato Kinugasa ◽  
Hanako Tamai ◽  
Mayu Miyake ◽  
Takashi Shimizu
Keyword(s):  
Blood Loss ◽  
Tranexamic Acid ◽  
Postpartum Hemorrhage ◽  
Balloon Catheter ◽  
Stable Condition ◽  
Total Blood Loss ◽  
Total Blood ◽  
Balloon Tamponade ◽  
First Case ◽  
Uterine Balloon Tamponade

While uterine balloon tamponade is an effective modality for control of postpartum hemorrhage, the reported success rates have ranged from the level of 60% to the level of 80%. In unsuccessful cases, more invasive interventions are needed, including hysterectomy as a last resort. We developed a modified tamponade method and applied it to two cases of refractory postpartum hemorrhage after vaginal delivery. The first case was accompanied by uterine myoma and low-lying placenta. After an induced delivery, the patient had excessive hemorrhage due to uterine atony. Despite oxytocin infusion and bimanual uterine compression, the total blood loss was estimated at 2,800 mL or more. The second case was diagnosed as placental abruption complicated by fetal death and severe disseminated intravascular coagulation, subsequently. A profuse hemorrhage continued despite administration of uterotonics, fluid, and blood transfusion. The total blood loss was more than 5,000 mL. In each case, an intrauterine balloon catheter was wrapped in gauze impregnated with tranexamic acid, inserted into the uterus, and inflated sufficiently with sterile water. In this way, mechanical compression by a balloon and a topical antifibrinolytic agent were combined together. This method brought complete hemostasis and no further treatments were needed. Both the women left hospital in stable condition.

scholarly journals Efficacy and Safety of Tranexamic Acid in Bimaxillary Orthognathic Surgery

2020 ◽  
Vol 28 (2) ◽  
pp. 94-104
Author(s):  
Liang Sun ◽  
Rui Guo ◽  
Yi Feng
Keyword(s):  
Blood Transfusion ◽  
Blood Loss ◽  
Tranexamic Acid ◽  
Orthognathic Surgery ◽  
Operation Time ◽  
Controlled Trials ◽  
Allogenic Blood Transfusion ◽  
Intraoperative Blood Loss ◽  
Irrigation Fluid ◽  
Allogenic Blood

Background: Tranexamic acid (TXA) has been widely used during craniofacial and orthognathic surgery (OS). However, results of the literature are inconsistent due to specific type of surgery and a small sample of studies. The purpose of this study was to evaluate the role of TXA in bimaxillary OS. Methods: We performed a comprehensive literature search of PubMed, Cochrane Central Register of Controlled Trials, and EMBASE to identify randomized controlled trials (RCTs) that compared effect of TXA on bimaxillary OS with placebo. Outcomes of interests included intraoperative blood loss, allogenic transfusion, operation time, and volume of irrigation fluid. Random effects models were chosen considering that heterogeneity between studies was anticipated, and I 2 statistics were used to test for the presence of heterogeneity. Results: Totally 6 RCTs were identified. Tranexamic acid resulted in significantly reduced intraoperative blood loss (weighted mean difference [WMD] = −264.82 mL; 95% CI: −380.60 to −149.04 mL) and decreased amounts of irrigation fluid (WMD = −229.23 mL; 95% CI: −399.63 to −58.83 mL). However, TXA had no remarkable impact on risk of allogenic blood transfusion (pooled risk ratio = 0.50; 95% CI: 0.20-1.23), operation time (WMD = −8.71 min; 95% CI: −20.98 to 3.57 min), and length of hospital stay (WMD = −0.24 day; 95% CI: −0.62 to 0.14 day). No TXA-associated severe adverse reactions or complications were observed. Conclusions: Currently available meta-analysis reveals that TXA is effective in decreasing intraoperative blood loss; however, it does not reduce the risk of allogenic blood transfusion in bimaxillary OS.

scholarly journals Use of tranexamic acid in total knee arthroplasty

Joints ◽  
2016 ◽  
Vol 04 (04) ◽  
pp. 202-213 ◽  
Author(s):  
Francesco Marra ◽  
Federica Rosso ◽  
Matteo Bruzzone ◽  
Davide Bonasia ◽  
Federico Dettoni ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Blood Loss ◽  
Tranexamic Acid ◽  
Knee Arthroplasty ◽  
Demographic Data ◽  
Level Of Evidence ◽  
Total Blood ◽  
Prospective Comparative Study ◽  
Total Knee ◽  
Student’S T

Purpose: different strategies have been developed to reduce blood loss in total knee arthroplasty (TKA). The efficacy of both systemic and local tranexamic acid (TXA) administration is demonstrated in the literature. The aim of the present study was to compare the efficacy of systemic, local and combined (systemic + local) administration of TXA in reducing blood loss after TKA. Methods: we enrolled all patients submitted to a primary TKA in our department between November 2014 and August 2015. They were divided into three groups corresponding to the method of TXA administration used: intravenous (IV), intra-articular (IA), and a combination of the two. Demographic data, as well as preoperative hemoglobin and platelet levels, were collected. The primary outcome was the maximum hemoglobin loss, while the secondary outcomes were the amount of blood in the drain (cc/hour) and the rate of transfusions; postoperative pain was also assessed. Student’s t-test or a χ2 test was used to evaluate between-group differences, using p<0.05 as the cut-off for statistically significant differences. Results: the sample comprised 34 patients: IV, 10 cases; IA, 15 cases, and combined (IV + IA), 9 cases. The average age of the patients was 71.1±6.4 years. No significant differences in the outcome measures were found between the groups, with the exception of a significantly lower maximum hemoglobin loss in the combined versus the IV group (p=0.02). There were no differences between the groups in the amount of blood in the drain or the rate of transfusions. Conclusions: the data from this preliminary study, as well as data from the literature, confirm that TXA administration is safe and effective in reducing total blood loss in TKA, and no administration protocol seems to be superior to the others. Level of evidence: Level II, prospective comparative study.

scholarly journals Intravenous and subsequent long-term oral tranexamic acid in enhanced-recovery primary total knee arthroplasty without the application of a tourniquet: a randomized placebo-controlled trial

2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Hao-Yang Wang ◽  
Liu Wang ◽  
Ze-Yu Luo ◽  
Duan Wang ◽  
Xin Tang ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Blood Loss ◽  
Tranexamic Acid ◽  
Knee Arthroplasty ◽  
Total Blood ◽  
Significant Difference ◽  
Group A ◽  
Total Knee ◽  
Group B

Abstract Background To assess the efficacy and safety of intravenous and subsequent long-term oral tranexamic acid (TXA) following total knee arthroplasty (TKA) without a tourniquet. Methods In this double-blinded trial, 118 patients undergoing primary TKA were randomized into two groups: the patients in group A received intravenous TXA at 20-mg/kg 10 min before the surgery and 3 h postoperatively, and then oral 1 g TXA from postoperative day (POD) 1 to POD 14, and the patients in group B received intravenous TXA at 20-mg/kg 10 min before surgery and 3 h postoperatively, and then oral 1 g placebo from postoperative day (POD) 1 to POD 14. The primary outcome was total blood loss. Secondary outcomes included ecchymosis area and morbidity, postoperative transfusion, postoperative laboratory values, postoperative knee function and length of hospital stay. Complications, and patient satisfaction were also recorded. Results The mean total blood loss was lower in Group A than in Group B (671.7 ml vs 915.8 ml, P = 0.001). There was no significant difference in the transfusion rate between the two groups. Group A had a higher hemoglobin than Group B on POD 3 (106.0 g/L vs 99.7 g/L, P = 0.001). However, no significant difference was found for Hb or hematocrit on POD 1 or POD 14 between the two groups. Patients in Group A had less ecchymosis morbidity (7 vs 38, P = 0.001), smaller ecchymosis area (1.6 vs 3.0, P = 0.001) than Group B. The blood coagulation level as measured by fibrinolysis (D-Dimer) was lower in Group A than in Group B on POD 1 and POD 3 (4.6 mg/L vs. 8.4 mg/L, respectively, P = 0.001; 1.5 mg/L vs. 3.3 mg/L, respectively, P = 0.001). However, there was no significant difference on POD 14, and the fibrin degradation products showed the same trend. Patients in Group A had less swelling than those in Group B on POD 3 and POD 14. The circumference of the knee was 43.1 cm vs. 46.1 cm (POD 3, P = 0.001) and 41.4 cm vs. 44.9 cm (POD 14, P = 0.001) in Group A vs Group B, respectively. Nevertheless, the circumference of the knee in the two groups was similar on POD 1 and POD 3 M. No significant differences were identified in knee function, pain score, or hospital stay. No significant differences were identified in thromboembolic complications, infection, hematoma, wound healing and patients satisfaction between the two groups. Conclusion Intravenous and subsequent long-term oral TXA produced less blood loss and less swelling and ecchymosis compared with short-term TXA without increasing the risk of complications. Trial registration The trial was registered in the Chinese Clinical Trial Registry (ChiCTR-IPR-17012264).

scholarly journals Hemostatic effect of tourniquet combined with tranexamic acid in total knee arthroplasty: a network meta-analysis

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Yimin Zhang ◽  
Bao Lang ◽  
Guifeng Zhao ◽  
Fengming Wang
Keyword(s):  
Total Knee Arthroplasty ◽  
Blood Transfusion ◽  
Blood Loss ◽  
Tranexamic Acid ◽  
Knee Arthroplasty ◽  
Meta Analysis ◽  
Total Blood Loss ◽  
Total Blood ◽  
Study Results ◽  
Total Knee

Abstract Background There are various techniques to reduce blood loss in total knee arthroplasty (TKA), including the use of a tourniquet and tranexamic acid (TXA). In this study, we studied the combined effect of TXA with a tourniquet on blood loss in the setting of primary TKA. Methods Randomized controlled trials (RCTs) of nine treatment methods were included (placebo, intravenous [i.v.] TXA, topical TXA, i.v.-combined topical TXA, oral TXA, placebo + tourniquet, i.v. TXA +tourniquet, topical TXA + tourniquet, and i.v.-combined topical TXA + tourniquet). The patients were divided into eight groups according to the different treatment strategies, with 30 cases per group. The differences in the total blood volume, the number of patients transfused, the hemoglobin before and after the operation, and complications after the operation were compared. Results Totally 15 RCTs meeting our inclusion criteria were collected in this study. Compared with the placebo + tourniquet group, the i.v. TXA + tourniquet group displayed lower hemoglobin reduction value, pulmonary embolism (PE) incidence, total blood loss, and blood transfusion risk; the topical TXA + tourniquet group showed reduced PE incidence, total blood loss, and blood transfusion risk, and the i.v.-combined topical TXA and i.v.-combined topical TXA + tourniquet groups showed decreased total blood loss and lower blood transfusion risk. Retrospective clinical study results also demonstrated that the efficacy of i.v.-combined topical TXA was the best. Conclusions Our meta-analysis indicates that i.v.-combined topical TXA provides a low total blood loss without increasing the blood transfusion risk in patients undergoing total knee replacement surgery.

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.

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