Jai-Gon Seo, Young-Wan Moon, Sang-Hoon Park, Sang-Min Kim, Kyung-Rae Ko
PURPOSE: Reduction in blood loss during surgery stabilizes hemodynamic status and aids in recovery after total knee arthroplasty (TKA). In this study, the authors examined whether different administration routes of tranexamic acid (TNA) might affect the amount of blood loss after TKA. METHODS: A total of 150 patients were prospectively allocated to each of the three groups (intravenous, intra-articular, and placebo group) and underwent unilateral TKA. During closing the operative wound, TNA (1...
August 2013: Knee Surgery, Sports Traumatology, Arthroscopy
Alexander Dastrup, Anton Pottegård, Jesper Hallas, Søren Overgaard
BACKGROUND: There have been concerns that the antifibrinolytic drug tranexamic acid (TXA) might increase the postoperative risk of cardiovascular events. Our objective was to determine whether perioperative TXA use is associated with cardiovascular events and death within 30 days after primary total hip arthroplasty (THA). METHODS: We conducted a nationwide cohort study of cardiovascular outcomes after perioperative exposure to tranexamic acid during THA. We included 45,290 patients who had a THA in the study period of 2006 to 2013; 38,586 received perioperative TXA, and 6,704 did not...
October 17, 2018: Journal of Bone and Joint Surgery. American Volume
Katerina Pavenski, Sarah E Ward, Gregory M T Hare, John Freedman, Robisa Pulendrarajah, Razak A Pirani, Nicholas Sheppard, Colm Vance, Alexander White, Nick Lo, James P Waddell, Alex Ho, Emil H Schemitsch, Mark Kataoka, Earl R Bogoch, Kiran Saini, C David Mazer, James E Baker
BACKGROUND: Tranexamic acid (TXA) therapy is effective in reducing postoperative red blood cell (RBC) transfusion in total joint arthroplasty (TJA), yet uncertainty persists regarding comparative efficacy and safety among specific patient subgroups. We assessed the impact of a universal TXA protocol on RBC transfusion, postoperative hemoglobin (Hb), and adverse outcomes to determine whether TXA is safe and effective in TJA, both overall and in clinically relevant subgroups. STUDY DESIGN AND METHODS: A retrospective observational study was performed on patients undergoing TJA at our institution spanning 1 year before and after the implementation of a universal protocol to administer intravenous (IV) TXA...
January 2019: Transfusion
Zeng Yi, Shen Bin, Yang Jing, Zhou Zongke, Kang Pengde, Pei Fuxing
BACKGROUND: The use of tranexamic acid (TXA) in primary total hip arthroplasty is well documented. However, considering the potential side effects, including deep vein thrombosis and pulmonary embolism, the ideal method of providing TXA to patients undergoing total hip arthroplasty remains controversial. The objective of this trial was to assess the efficacy and safety of intravenous (IV) administration combined with topical administration of TXA regarding postoperative blood loss and transfusion rates in patients treated with primary unilateral total hip arthroplasty...
June 15, 2016: Journal of Bone and Joint Surgery. American Volume
Yvonne E Kaptein
Tranexamic acid (TXA) is an antifibrinolytic which minimises bleeding and transfusions, with thrombotic risk. Our patient had known coronary artery disease with post-TXA acute ST-elevation myocardial infarction (STEMI) due to in-stent thrombosis. He had five drug-eluting stents (DES): two overlapping DES in mid-LAD (3 years ago), and two overlapping DES in distal right coronary artery and one DES in obtuse-marginal (1.5 years ago). After TXA, both overlapping stent locations thrombosed. Of nine reports of post-TXA acute MI, only one had complex stent anatomy (bifurcation stent to left circumflex/first obtuse-marginal) with other single stents, and only the complex stent thrombosed...
April 8, 2019: BMJ Case Reports
Mikkel Gybel, Kjeld Kristensen, Natasha Roseva-Nielsen
Pulmonary embolism (PE) as the direct cause of cardiac arrest is well known but probably under-diagnosed. Treatment of menorrhagia with antifibrinolytics is a well documented treatment modality and it is considered safe although thromboembolic complications have been reported. We describe a case of a 30-year-old otherwise healthy woman, who had been treated with antifibrinolytics for up to six months prior to the event, presenting with fatal acute, massive PE and cardiac arrest, which was treated with prompt resuscitation including thrombolysis with recombinant tissue plasminogen activator and subsequent return of spontaneous circulation...
May 13, 2013: Ugeskrift for Laeger
Sung Yup Lee, Suri Chong, Dhanasekaraprabu Balasubramanian, Young Gon Na, Tae Kyun Kim
BACKGROUND: TKA commonly involves substantial blood loss and tranexamic acid has been used to reduce blood loss after TKA. Numerous clinical trials have documented the efficacy and safety of intravenous (IV) or intraarticular (IA) use of tranexamic acid. Combined administration of tranexamic acid also has been suggested; however, there is no consensus regarding the ideal route of tranexamic acid administration. QUESTIONS/PURPOSES: (1) To compare the efficacy of tranexamic acid in terms of total blood loss and the allogeneic transfusion rate among three routes of administration: IV alone, IA alone, and combined IV and IA...
August 2017: Clinical Orthopaedics and related Research
Paul J Zufferey, Julien Lanoiselée, Céline Chapelle, Dmitry B Borisov, Jean-Yves Bien, Pierre Lambert, Rémi Philippot, Serge Molliex, Xavier Delavenne
BACKGROUND: Preoperative administration of the antifibrinolytic agent tranexamic acid reduces bleeding in patients undergoing hip arthroplasty. Increased fibrinolytic activity is maintained throughout the first day postoperation. The objective of the study was to determine whether additional perioperative administration of tranexamic acid would further reduce blood loss. METHODS: This prospective, double-blind, parallel-arm, randomized, superiority study was conducted in 168 patients undergoing unilateral primary hip arthroplasty...
September 2017: Anesthesiology
Philipp Stein, Jan-Dirk Studt, Roland Albrecht, Stefan Müller, Dieter von Ow, Simon Fischer, Burkhardt Seifert, Sergio Mariotti, Donat R Spahn, Oliver M Theusinger
BACKGROUND: There is limited data on prehospital administration of tranexamic acid (TXA) in civilian trauma. The aim of this study was to evaluate changes in coagulation after severe trauma from on-scene to the hospital after TXA application in comparison to a previous study without TXA. METHODS: The study protocol was registered at (NCT02354885). A prospective, multicenter, observational study investigating coagulation status in 70 trauma patients receiving TXA (1 g intravenously) on-scene versus a control group of 38 patients previously published without TXA...
February 2018: Anesthesia and Analgesia
Bhavna Hooda, Rajendra Singh Chouhan, Girija Prasad Rath, Parmod Kumar Bithal, Ashish Suri, Ritesh Lamsal
Surgical excision of meningioma is often complicated by significant blood loss requiring blood transfusion with its attendant risks. Although tranexamic acid is used to reduce perioperative blood loss, its blood conservation effect is uncertain in neurosurgery. Sixty adults undergoing elective craniotomy for meningioma excision were randomized to receive either tranexamic acid or placebo, initiated prior to skin incision. Patients in the tranexamic acid group received intravenous bolus of 20mg/kg over 20min followed by an infusion of 1mg/kg/h till the conclusion of surgery...
July 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
M Panteli, I Pountos, P V Giannoudis
Severe trauma and massive haemorrhage represent the leading cause of death and disability in patients under the age of 45 years in the developed world. Even though much advancement has been made in our understanding of the pathophysiology and management of trauma, outcomes from massive haemorrhage remain poor. This can be partially explained by the development of coagulopathy, acidosis and hypothermia, a pathological process collectively known as the "lethal triad" of trauma. A number of pharmacological adjuncts have been utilised to stop bleeding, with a wide variation in the safety and efficacy profiles...
June 2016: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
S Jervis, T Saunders, J Belcher, D Skinner
No abstract text is available yet for this article.
April 2017: Clinical Otolaryngology
David Clinkard, David Barbic
CLINICAL QUESTION: Does the application of topical tranexamic acid reduce bleeding as compared to anterior packing? ARTICLE CHOSEN: Zahed R, Moharamzadeh P, Alizadeharasi S, et al. A new and rapid method for epistaxis treatment using injectable form of tranexamic acid topically: a randomized controlled trial. Am J Emerg Med 2013;31(9):1389-92. OBJECTIVES: To determine if topically applied tranexamic acid reduces bleeding time in epistaxis...
January 2016: CJEM
Luis Bahamondes, Moazzam Ali
Menstrual disorders are a major reason for gynaecological consultations worldwide and, unfortunately there are many different definitions and classifications of this condition. Clear definitions and terminology are necessary for scientific literature, particularly for clinicians, and for clinical trials comparing two treatments. The International Federation of Gynaecology and Obstetrics (FIGO) Menstrual Disorders Working Group has proposed abandoning the use of one common term, dysfunctional uterine bleeding (DUB), while continuing to use the terms abnormal uterine bleeding (AUB) and heavy menstrual bleeding (HMB)...
2015: F1000Prime Reports
Takeshi Uzuka, Masanori Nakamura, Yohsuke Kuroda, Noriyasu Watanabe
This paper reports on the therapeutic use of tranexamic acid in an elderly patient with severe comorbidities that precluded even endovascular reintervention. Orally administered tranexamic acid mitigated and partially reversed two and a half years of progressive aneurysmal expansion and closed a persistent endoleak after thoracic endovascular aneurysm repair and endovascular aneurysm repair for coexisting lesions. Reappearance of the endoleak when tranexamic acid was accidentally stopped and its re-closure after the resumption of tranexamic acid treatment confirmed causality...
August 2015: Interactive Cardiovascular and Thoracic Surgery
Chih-Yuan Lin, Jeffery H Shuhaiber, Hugo Loyola, Hua Liu, Pedro Del Nido, James A DiNardo, Frank A Pigula
BACKGROUND: Neonates undergoing open-heart surgery are particularly at risk of postoperative bleeding requiring blood transfusion. Aprotinin has attained high efficacy in reducing the requirement for a blood transfusion following a cardiopulmonary bypass, but is seldom studied in the neonatal age group. The aim of this study was to compare the efficacy and adverse effects of aprotinin and tranexamic acid in neonates undergoing open-heart surgery at a single centre. METHODS: Between October 2003 and March 2008, perioperative data of 552 consecutive neonatal patients undergoing open-heart surgery in Children's Hospital Boston were reviewed...
2015: PloS One
Katharine Ker, Ian Roberts, Haleema Shakur, Tim J Coats
BACKGROUND: Uncontrolled bleeding is an important cause of death in trauma victims. Antifibrinolytic treatment has been shown to reduce blood loss following surgery and may also be effective in reducing blood loss following trauma. OBJECTIVES: To assess the effect of antifibrinolytic drugs in patients with acute traumatic injury. SEARCH METHODS: We ran the most recent search in January 2015. We searched the Cochrane Injuries Group's Specialised Register, The Cochrane Library, Ovid MEDLINE(R), Ovid MEDLINE(R) In-Process & Other Non-Indexed Citations, Ovid MEDLINE(R) Daily and Ovid OLDMEDLINE(R), Embase Classic+Embase (OvidSP), PubMed and clinical trials registries...
May 9, 2015: Cochrane Database of Systematic Reviews
Pablo Perel, Ian Roberts, Haleema Shakur, Bandit Thinkhamrop, Nakornchai Phuenpathom, Surakrant Yutthakasemsunt
No abstract text is available yet for this article.
May 13, 2015: Cochrane Database of Systematic Reviews
Jennifer Robertson, Alex Koyfman
No abstract text is available yet for this article.
April 2015: Annals of Emergency Medicine
Lilian Tengborn, Margareta Blombäck, Erik Berntorp
Experience with tranexamic acid, an indirect fibrinolytic inhibitor, started as soon as it was released from Shosuke Okamoto's lab in the early 1960s. It was first prescribed to females with heavy menstrual blood loss and to patients with hereditary bleeding disorders. Soon the indications were widened to elective surgery because of its blood saving effects. Contraindications are few, most important is ongoing venous or arterial thrombosis and allergy to tranexamic acid, and the doses has to be reduced in renal insufficiency...
February 2015: Thrombosis Research
2015-02-04 16:54:24
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