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 ◽  
Qiuping Xiao ◽  
Jianfeng He ◽  
Tianji Huang ◽  
Wantang Xu ◽  
...  
Keyword(s):  
Blood Transfusion ◽  
Blood Loss ◽  
Elderly Patients ◽  
Tranexamic Acid ◽  
Topical Application ◽  
Control Group ◽  
Specific Method ◽  
Intertrochanteric Fractures ◽  
Perioperative Blood Loss ◽  
Perioperative Bleeding

Abstract Background: The specific method and dose of tranexamic acid (TXA) topically applied for intertrochanteric fractures have not been well established. The aim of this study is to investigate the efficacy and safety of TXA topically administered via our protocol for perioperative bleeding management in elderly patients with intertrochanteric fractures who underwent proximal femoral nail anti-rotation (PFNA).Methods: A retrospective comparative analysis was performed. The TXA group was composed of 82 patients with topical use of TXA, and the control group was composed of 82 patients without TXA use during the PFNA procedure. Intraoperative, total and hidden amounts of blood loss, drainage volumes, postoperative blood transfusion volumes and complications were compared between the two groups.Results: The intraoperative, total and hidden amounts of blood loss and the drainage volumes were significantly lower in the TXA group than 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 the TXA group were significantly lower than those in the control group (P<0.01). There were no significant differences in complications between the two groups (P>0.05).Conclusion: Topical application of TXA offers an effective and safe option for reducing perioperative blood loss and transfusion in elderly patients with intertrochanteric fractures undergoing 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 Tranexamic Acid has no Effect on Post-Operative Hemarthrosis or Pain Control Following ACL Reconstruction Using Bone Patella Tendon Bone Autograft: A Double-Blind Randomized Controlled Double-Blind Trial (169)

2021 ◽  
Vol 9 (10_suppl5) ◽  
pp. 2325967121S0029
Author(s):  
Jordan Fried ◽  
David Bloom ◽  
Samuel Baron ◽  
Eoghan Hurley ◽  
Jovan Popovic ◽  
...  
Keyword(s):  
Blood Loss ◽  
Tranexamic Acid ◽  
Acl Reconstruction ◽  
Control Group ◽  
Patella Tendon ◽  
Double Blind ◽  
Randomized Controlled ◽  
Perioperative Blood Loss ◽  
Significant Difference ◽  
Experimental Group

Objectives: Tranexamic acid (TXA) is a commonly used medication in orthopaedic procedures, reducing perioperative bleeding and need for transfusion. The purpose of this double-blind randomized controlled study was to evaluate if IV TXA for primary anterior cruciate ligament (ACL) reconstruction with bone-patella tendon-bone (BTB) could reduce perioperative blood loss or postoperative intra-articular hemarthrosis without postoperative drains. Methods: A controlled, randomized, double-blinded trial was conducted in 110 patients who underwent ACLR with BTB autograft. Patients were equally randomized to the control and experimental groups. The experimental group received two 1-gram boluses of IV TXA, one prior to tourniquet inflation and one prior to wound closure; the control group did not receive TXA. If a clinically significant hemarthrosis was evident, the knee was aspirated, and the volume of blood (ml) was recorded. Additionally, perioperative blood loss (ml); Visual Analog Scale (VAS) on postoperative days (POD) 1-7 and post-operative weeks (POW) 1, 6 and 12; postoperative opioid consumption POD 1-7; range of motion (ROM) and ability to straight leg raise (SLR) at POW 1, 6, 12; and pre and postoperative thigh circumference ratio (TCR). Results: There was no significant difference in perioperative blood loss between the experimental and control groups (32.5ml v. 35.6ml, p=0.47). The experimental group had 23 knees aspirated; control group had 26 knees aspirated (p=0.56). No significant difference seen in postoperative hemarthrosis volume with IV TXA (26.7ml v. 37.3ml, p=0.12). There was no significant difference in VAS score between the two groups (p=0.15), additionally, there was no difference in postoperative opioid consumption (p=0.33). There was no significant difference in ROM or ability to SLR, or pre- nor post-operative TCR (p > 0.05 for all). Conclusions: IV TXA in patients who undergo ACLR with BTB autograft does not significantly impact perioperative blood loss, postoperative hemarthrosis, or postoperative pain levels. Additionally, no significant differences were seen in early post-operative recovery regarding ROM or quadriceps reactivation.

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.

Tranexamic Acid Effectively Reduces Blood Loss and Transfusion Rates during Simultaneous Bilateral Total Knee Arthroplasty

2017 ◽  
Vol 31 (03) ◽  
pp. 270-276 ◽  
Author(s):  
Hernan Prieto ◽  
Heather Vincent ◽  
Justin Deen ◽  
Dane Iams ◽  
Hari Parvataneni
Keyword(s):  
Total Knee Arthroplasty ◽  
Blood Transfusion ◽  
Blood Loss ◽  
Tranexamic Acid ◽  
Knee Arthroplasty ◽  
Control Group ◽  
Level Of Evidence ◽  
Estimated Blood Loss ◽  
Flexion Extension ◽  
Total Knee

AbstractTranexamic acid (TXA) can reduce blood loss and decrease transfusion rates after total knee arthroplasty (TKA). The purpose of our study was to evaluate the efficacy of TXA in a homogenous, consecutive cohort of patients undergoing simultaneous bilateral primary TKA. This was a retrospective study of 50 consecutive patients who underwent bilateral simultaneous primary TKA between 2011 and 2015. Of these, 20 patients received TXA and 30 patients did not receive TXA and served as the control group. Primary outcome measurements were intraoperative estimated blood loss, hemoglobin (Hb) and Hematocrit (Hct) levels on postoperative day (POD) 1 and POD2, and blood transfusion rates. Secondary outcomes included length of stay (LOS), knee flexion/extension range of motion (ROM), and postoperative complications. There was no difference between groups for preoperative Hb and Hct (all p > 0.05). The TXA group demonstrate higher Hb levels at POD1 (11.7 in TXA vs. 10.4 controls; p < 0.001) and POD2 (10.5 in TXA vs. 9.6 controls; p < 0.001), as well as higher Hct levels at POD1 (35.6 in TXA vs. 32.1 controls; p < 0.001) and POD2 (31.9 in TXA vs. 29.3 controls; p < 0.001). There was less percentage variation in Hb levels in the TXA group from preoperative to POD1 (17.7% in TXA vs. 25.7% controls; p < 0.0001) and POD2 (26.1% TXA vs. 31.8% controls; p = 0.019). Similarly, less percentage variation in Hct levels in the TXA group from presurgery to POD1 (17.0% TXA vs. 25.7% controls; p < 0.0001) and POD2 (25.0% TXA vs. 31.3% controls; p = 0.005). A total of 23.3% of patients in the control group required transfusions compared with no patients in the TXA (p = 0.044). There were no differences in LOS, knee ROM, or number of complications. No thromboembolic events occurred. TXA in bilateral simultaneous TKA effectively reduces blood loss, maintains postoperative Hb and Hct levels, and significantly decreases blood transfusion rates. The level of evidence is level III (therapeutic study).

scholarly journals Efficacy of Tranexamic Acid in Pediatric Craniosynostosis Surgery

2011 ◽  
Vol 114 (4) ◽  
pp. 862-871 ◽  
Author(s):  
Susan M. Goobie ◽  
Petra M. Meier ◽  
Luis M. Pereira ◽  
Francis X. McGowan ◽  
Randy P. Prescilla ◽  
...  
Keyword(s):  
Blood Transfusion ◽  
Blood Loss ◽  
Tranexamic Acid ◽  
Plasma Concentrations ◽  
Secondary Outcome ◽  
Double Blind ◽  
Total Blood ◽  
Reconstruction Surgery ◽  
Perioperative Blood Loss ◽  
The Difference

Background Extensive blood loss is common in pediatric craniosynostosis reconstruction surgery. Tranexamic acid (TXA) is increasingly used to reduce perioperative blood loss in various settings, but data on its efficacy are limited in children. The purpose of this randomized, double-blind, placebo-controlled, parallel trial was to evaluate the efficacy of TXA in pediatric craniosynostosis correction surgery. The primary and secondary outcome variables were reduction in perioperative blood loss and reduction in blood transfusion, respectively. Methods Forty-three children, ages 2 months to 6 yr, received either placebo or TXA in a loading dose of 50 mg·kg(-1), followed by an infusion of 5 mg·kg·h(-1) during surgery. TXA plasma concentrations were measured. Results The TXA group had significantly lower perioperative mean blood loss (65 vs. 119 ml·kg(-1), P &lt; 0.001) and lower perioperative mean blood transfusion (33 vs. 56 ml· kg(-1), P = 0.006) compared to the placebo group. The mean difference between the TXA and placebo groups for total blood loss was 54 ml·kg(-1) (95% CI for the difference, 23-84 ml·kg(-1)) and for packed erythrocytes transfused was 23 ml·kg(-1) (95% CI for the difference, 7-39 ml·kg(-1)). TXA administration also significantly diminished (by two thirds) the perioperative exposure of patients to transfused blood (median, 1 unit vs. 3 units; P &lt; 0.001). TXA plasma concentrations were maintained above the in vitro thresholds reported for inhibition of fibrinolysis (10 μg·ml(-1)) and plasmin-induced platelet activation (16 μg·ml(-1)) throughout the infusion. Conclusions TXA is effective in reducing perioperative blood loss and transfusion requirement in children undergoing craniosynostosis reconstruction surgery.

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.

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