Tranexamic acid reduces the blood loss and blood transfusion requirements following peri-acetabular osteotomy

2015 ◽  
Vol 97-B (12) ◽  
pp. 1604-1607 ◽  
Author(s):  
G. I. Wassilew ◽  
C. Perka ◽  
V. Janz ◽  
M. Krämer ◽  
L. Renner
Keyword(s):  
Blood Transfusion ◽  
Blood Loss ◽  
Tranexamic Acid ◽  
Transfusion Requirements

scholarly journals 1484 Tranexamic Acid Use to Decrease Blood Loss in Primary Shoulder and Elbow Replacement: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
J Varma ◽  
R Donovan ◽  
M Whitehouse ◽  
S Kunutsor ◽  
A Blom
Keyword(s):  
Systematic Review ◽  
Blood Transfusion ◽  
Length Of Stay ◽  
Blood Loss ◽  
Tranexamic Acid ◽  
Meta Analysis ◽  
Postoperative Blood Loss ◽  
Perioperative Blood Loss ◽  
Transfusion Requirements ◽  
Elbow Replacement

Abstract Tranexamic acid (TXA) is an inexpensive, commonly used antifibrinolytic agent that has been shown to significantly reduce perioperative blood loss and transfusion requirements after total hip and knee replacement. We conducted a systematic review and meta-analysis to synthesise the latest evidence regarding the effects of TXA on blood loss in total shoulder replacement (TSR) and total elbow replacement (TER). We systematically searched MEDLINE, EMBASE and CENTRAL from inception to 03 September 2020 for randomised controlled trial (RCTs) and observational studies. Our primary outcome was blood loss, and secondary outcomes included the need for blood transfusion and venous thromboembolic (VTE) complications. Four RCTs and five retrospective cohort studies (RCS) met eligibility criteria for TSRs, but none for TERs. RCT data determined that TXA administration significantly decreased estimated total blood loss, postoperative blood loss, change in haemoglobin (Hb) and total Hb loss when compared to placebo. RCS data demonstrated significant association between TXA administration and decreased in postoperative blood loss, change in Hb, change in Hct and length of stay. This meta-analysis demonstrates that TXA administration in primary TSR significantly decreases blood loss compared with placebo and is associated with lower blood loss and shorter length of stay compared with no treatment with no increase in VTE complications. TXA administration should be part of a wider blood management strategy to minimise perioperative blood loss and blood transfusion requirements in patients undergoing TSR. Further research is needed to demonstrate if a similar treatment benefit exists in patients undergoing TER.

441 Intravenous Tranexamic Acid Given at Femoral Fragility Fracture Surgery Reduces Blood Transfusion Requirements Four-Fold

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
M Powell-Bowns ◽  
R Olley ◽  
C McCann ◽  
J Balfour ◽  
C Brennan ◽  
...  
Keyword(s):  
Blood Transfusion ◽  
Blood Loss ◽  
Tranexamic Acid ◽  
Fragility Fracture ◽  
Mean Difference ◽  
Complication Rates ◽  
Postoperative Blood Transfusion ◽  
Transfusion Requirements ◽  
Significant Difference ◽  
Fracture Surgery

Abstract Introduction Tranexamic acid (TXA) is proven to reduce blood loss in several surgical fields, but its use in femoral fragility fracture (FFF) management is ill defined. This study examined the effect of intraoperative TXA on the rate of postoperative blood transfusion following FFF. Method A prospective non-randomized case-control study of 361 consecutive patients admitted to the study centre with FFFs over a 4-month period was performed. Intravenous TXA 1g was administered intraoperatively at the discretion of the operating team: 178 patients received TXA and 183 did not. Results Patients given TXA required fewer blood transfusions: 15/178 (8.4%) vs controls 58/183 (31.7%), (p < 0.001). Calculated blood loss (mean difference -222ml (-337 to -106, 95%CI), p < 0.001) and percentage drop in Hb (mean difference -4.3% (-6.3 to -2.3, 95%CI), p < 0.001) were significantly lower in the TXA group. The difference in CBL was greatest following intramedullary nail (n = 49: mean difference -394ml, p = 0.030) and DHS (n = 101, mean difference -216ml, p = 0.032). There was no significant difference in complication rates: venous thromboembolism TXA 2/178 vs control 1/182 (p = 0.620); MI/stroke/TIA 2/178 vs 0/182 (p = 0.244) Conclusions Intraoperative intravenous TXA significantly reduced calculated blood loss and blood transfusion requirements following femoral fragility fracture surgery without increasing the rate of complications.

scholarly journals Does prophylactic tranexamic acid reduce blood loss in Indian women following vaginal delivery?

2021 ◽  
Vol 10 (2) ◽  
pp. 497
Author(s):  
Nivedhana Arthi P. ◽  
Indu N. R. ◽  
Jalakandan B.
Keyword(s):  
Blood Transfusion ◽  
Blood Loss ◽  
Tranexamic Acid ◽  
Vaginal Delivery ◽  
Controlled Study ◽  
Reduce Blood Loss ◽  
Indian Women ◽  
Estimated Blood Loss ◽  
Transfusion Requirements ◽  
Significant Difference

Background: Postpartum hemorrhage (PPH) accounts for 25% to 33% of obstetric deaths every year. Anemia is a cause and consequence of PPH. Despite intense efforts to prevent anemia, many Indian women labour with low hemoglobin levels. Tranexamic acid (TXA), an antifibrinolytic, have been demonstrated to reduce blood loss and transfusion requirements in various surgeries including cesarean section. Objectives were to study the efficacy of TXA in effectively reducing blood loss in Indian women following vaginal delivery.Methods: This randomized, double-blind, placebo-controlled study was conducted on 200 patients scheduled for vaginal delivery. In addition to oxytocin 10 units, group T received TXA 15 mg/kg and group P received normal saline administered over 5 minutes. Estimated blood loss, Hemoglobin deficit, need for additional uterotonics, need for blood transfusion, incidence of PPH and adverse events were noted.Results: The fall in hemoglobin was significantly higher in group P (p<0.00001). Estimated 24 hour blood loss was significantly higher by a mean blood volume of 86.99 ml in group P compared to group T (p<0.00001). The incidence of PPH was lower in group T (2.8% versus 11.3%). There were no significant difference in the need for supplementary uterotonics (9.9% versus 15.5%) and the incidence of blood transfusion (2.8% versus 8.5%). No adverse maternal and fetal outcomes were noted.Conclusions: To reduce blood loss following vaginal delivery, TXA may be safely recommended as standard adjunct to Oxytocin for regular management of third stage of labour, especially in developing countries like India.

scholarly journals Effect of prophylactic tranexamic acid on blood conservation in Indian women undergoing abdominal hysterectomy

2018 ◽  
Vol 7 (9) ◽  
pp. 3538 ◽  
Author(s):  
Nivedhana Arthi P. ◽  
Jalakandan B. ◽  
Gunaseelan S.
Keyword(s):  
Blood Transfusion ◽  
Blood Loss ◽  
Tranexamic Acid ◽  
Normal Saline ◽  
Abdominal Hysterectomy ◽  
Controlled Study ◽  
Risk Of Death ◽  
Transfusion Requirements ◽  
Significant Difference ◽  
Duration Of Surgery

Background: The prevalence of anemia in India is so high that majority of women presenting for hysterectomy are already with borderline hemoglobin status and the perioperative blood loss puts them at risk of death and prolongs recovery. Antifibrinolytic agents, mainly Tranexamic acid (TXA) have been demonstrated to reduce blood loss and transfusion requirements in various surgeries. The present study was done to assess the efficacy of TXA in effectively reducing intraoperative blood loss and the need for transfusion in Indian population undergoing abdominal hysterectomy for benign indications.Methods: This randomized, double-blind, placebo-controlled study was conducted on hundred patients undergoing abdominal hysterectomy. Group T (n = 50)- received TXA 15 mg/kg in 100 ml Normal saline and Group N (n = 50)-received the same volume of Normal saline infused over 15 minutes. Estimated blood loss need for blood transfusion, duration of surgery, postoperative hemoglobin and incidence of adverse events were noted.Results: There was statistically significant reduction in mean blood loss in group T when compared to group N (360 ml versus 540 ml). Accordingly, there was significant difference in the number of patients requiring blood transfusion (12% versus 42%) and also the postoperative hemoglobin levels. The group T patients had a significantly shorter operating time (127.86 versus 148.64 minutes). None of the patients developed any major adverse events.Conclusions: The prophylactic TXA safely and effectively reduces the blood loss and transfusion requirements in Indian patients undergoing abdominal hysterectomy for benign indications.

EFFECT OF TRANEXAMIC ACID IN REDUCING BLOOD LOSS DURING THORACOLUMBAR SPINE SURGERY

2021 ◽  
pp. 32-34
Author(s):  
Santhi KS ◽  
Smrithi JP ◽  
Susan T Cheeran
Keyword(s):  
Blood Transfusion ◽  
Blood Loss ◽  
Tranexamic Acid ◽  
Spine Surgery ◽  
Normal Saline ◽  
Thoracolumbar Spine ◽  
Hemodynamic Instability ◽  
Blood Transfusions ◽  
Perioperative Blood Loss ◽  
Transfusion Requirements

BACKGROUND: Spine surgeries are usually associated with excessive blood loss, which increases morbidity and mortality due to hemodynamic instability and subsequent blood transfusions. Tranexamic acid (TXA), an antibrinolytic drug, inhibits the activation of plasminogen, is found to be useful in reducing blood loss. METHODOLOGY: A prospective observational study conducted in Government Medical College, Kottayam for a period of twelve months, randomly assigned forty-eight adult patients (ASA I or II) undergoing thoracolumbar spine surgery into two groups, who received either a bolus of 10 mg/kg IV TXA after induction followed by an infusion of 1 mg/kg/h of TXA up to closure of skin, or an equivalent volume of normal saline. Blood investigations, surgical parameters, perioperative blood loss and blood transfusions were assessed. RESULTS: Both groups in the study were comparable with respect to demographic variables, baseline laboratory indices and surgical parameters. The mean perioperative blood loss was 44% less (P<0.05) and blood transfusion requirements were 71% reduced (P<0.05) in patients who received TXA. Mean surgical duration as well as postoperative hemoglobin drop was signicantly reduced in TXA group compared to Normal Saline group (NS). CONCLUSION: Tranexamic acid reduces perioperative blood loss and blood transfusion.

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.

Tranexamic acid reduces blood loss and need of blood transfusion in hemiarthroplasty: An observational study

2020 ◽  
Vol 7 (1) ◽  
pp. 24
Author(s):  
Sangeetha Gopinath ◽  
AnoopSivasankara Pillai ◽  
Sreelakshmi Pallipurathu Raghunath
Keyword(s):  
Blood Transfusion ◽  
Blood Loss ◽  
Observational Study ◽  
Tranexamic Acid

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 The Use of Tranexamic Acid in Total Ankle Arthroplasty

2019 ◽  
Vol 4 (4) ◽  
pp. 2473011419S0028
Author(s):  
Laura Luick ◽  
Vytas Ringus ◽  
Garrett Steinmetz ◽  
Spencer Falcon ◽  
Shaun Tkach ◽  
...  
Keyword(s):  
Blood Transfusion ◽  
Blood Loss ◽  
Tranexamic Acid ◽  
Total Ankle Arthroplasty ◽  
Wound Complications ◽  
P Value ◽  
Ankle Arthroplasty ◽  
Estimated Blood Loss ◽  
Number Of Patients ◽  
Significant Difference

Category: Ankle Arthritis Introduction/Purpose: The number of total ankle arthroplasties (TAA) is on the rise. Complications associated with TAA include need for blood transfusion, deep vein thrombosis, hematoma, infection, and wound complications. Tranexamic acid (TXA) use in the total knee and total hip population has been found to decrease the rate of blood transfusion. The rate of infections and blood transfusions in TAA was reported to be 3.2% and 1.3%, respectively. In calcaneal fractures TXA was found to decrease wound complications. Our goal was to evaluate the use of TXA in the TAA population to see if its use decreases blood loss or wound complications. Methods: This is a retrospective review of two patient cohorts operated on by a single surgeon from 2010 to 2016. We compared a group of TAA patients that did not receive TXA versus a subsequent group that received TXA. Patients received 1 g IV TXA before tourniquet was inflated and another 1 g following the release of the tourniquet. Pre-operative hemoglobin and hematocrit levels were compared to postoperative levels. Post-operative complications were compared between the two groups. Results: 87 patients were included in the study. 35 patients (40%) received TXA. In patients that received TXA, 18 had postoperative hemoglobin levels available. These patients were compared to a control cohort of 52 patients that did not receive TXA. No significant difference existed between the two groups in gender or age (p=0.9; p=0.7 respectively). Mean estimated blood loss was the same between the two groups. Overall postoperative complications, including wound complications, were higher in the TXA group at 26% vs 12% but this was not statistically significant (p-value = 0.086). The preoperative to postoperative change in hemoglobin/hematocrit levels was not statistically significant between groups (p-value = 0.78). There was one transfusion required in the non-TXA group and no transfusions required in the TXA group (p=0.9). Conclusion: The use of TXA was not found to provide a beneficial effect in total ankle arthroplasty in either decreasing wound complications or blood loss. Given these results, TXA use might not be cost effective in total ankle arthroplasty as opposed to other total joint arthroplasties. Further higher levels studies with increased number of patients are required to further evaluate TXA effectiveness in TAA.

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