scholarly journals A tranexámsav vérvesztést és kis vérzéses szövődményeket befolyásoló hatása cementes csípőprotézis beültetése után

2019 ◽  
Vol 160 (12) ◽  
pp. 456-463
Author(s):  
Csaba Gombár ◽  
Hristifor Gálity ◽  
Miklós Bácsi ◽  
Krisztián Sisák
Keyword(s):  
Blood Loss ◽  
Tranexamic Acid ◽  
Hip Replacement ◽  
Large Scale ◽  
Transfusion Requirement ◽  
Skin Surface ◽  
Bleeding Complications ◽  
Control Group ◽  
Minor Bleeding ◽  
Long Term Outcome

Abstract: Introduction: Tranexamic acid (TXA) is widely used during elective joint replacement to reduce blood loss and decrease the transfusion requirement. Aim:This study assessed the efficacy of tranexamic acid in reducing minor bleeding complications following primary cemented total hip replacement, when rivaroxaban is used as thromboprophylaxis, the complicated wound healing effect of which has been published recently. Method: Consecutive patients undergoing hip replacement were studied. Patients receiving tranexamic acid perioperatively between January 2014 and November 2014 were designated as the TXA-group. We compared these data with those of a group of patients who underwent the same procedure between February 2012 and December 2012 (control group), before the introduction of tranexamic acid. The authors investigated the effect of tranexamic acid on surgical wound bleeding and discharge, area of hematoma on the skin surface, thigh volume changes, calculated perioperative blood loss and transfusion requirement. Results: 168 patients, 81 in the TXA-group and 87 in the control group were included. The extent of postoperative thigh swelling was significantly less in the TXA-group, 270.3 mL (129.1–449.0) as compared with the control group, 539.8 mL (350.0–864.8, p<0.001). Tranexamic acid significantly reduced wound bleeding during the first 24 hours postoperatively (p<0.001). The amount of calculated blood loss was significantly less in the TXA-group (1150 mL [780–1496] versus 1579 mL [1313–2074] in the control group, p<0.001). Transfusion requirement was remarkably lower in the TXA-group than in the control group (15% versus 39%). Conclusions: Tranexamic acid reduces postoperative thigh volume, wound bleeding and area of hematoma on the skin surface when rivaroxaban is used as the anticoagulant. Further large scale studies could help establish the clinical relevance and long-term outcome of minor bleeding complications. Orv Hetil. 2019; 160(12): 456–463.

scholarly journals A prospective study to assess the efficacy of tranexamic acid in reducing blood loss during total hip arthroplasty

2019 ◽  
Vol 5 (6) ◽  
pp. 1156
Author(s):  
Vikas Kumar Lochab ◽  
Saumya Agarwal ◽  
Shivank Prakash ◽  
Somnath T. Sanikop
Keyword(s):  
Deep Vein Thrombosis ◽  
Blood Loss ◽  
Tranexamic Acid ◽  
Hip Replacement ◽  
Test Group ◽  
Control Group ◽  
Total Hip ◽  
Vein Thrombosis ◽  
Before And After ◽  
Deep Vein

<p class="abstract"><strong>Background:</strong> Tranexamic acid has been reported to reduce bleeding, risk of thromboembolic events and the need for allogenic blood transfusion in total hip replacement patients. The present study was conducted to assess the efficacy of tranexamic acid in reducing blood loss during total hip replacement surgery.</p><p class="abstract"><strong>Methods:</strong> Total hip arthroplasty patients (n=60) were divided into control and test groups with 30 patients each. Test group was administered with tranexamic acid (15 mg/kg) for 15 min before and after the surgery. Patients were administered cefuroxime (1.5 g), 30 min prior to the surgery and deep vein thrombosis prophylaxis; enoxaparin (40 mg), 48 hours after surgery. Demographic details along with levels of hemoglobin and blood loss before, during and after the surgery were recorded.<strong></strong></p><p class="abstract"><strong>Results:</strong> Tranexamic acid reduced the early post-surgical blood loss (292±132.38 vs. 155.8±86.56 ml; p&lt;0.0001), total blood loss (989.6±340.98 vs. 580.4±131.88 ml; p&lt;0.0001), and the blood loss during surgery (723.5±277.73 vs. 434.3±131.83 ml; p&lt;0.05). Test group required fewer transfusions (6.7%) than control group (26%) and had no increased incidence of deep-vein thrombosis. Postsurgical hemoglobin in the control group had significantly reduced as compared to test group.</p><p><strong>Conclusions:</strong> Administration of intravenous tranexamic acid before and after the surgery was effective in reducing the blood loss and transfusion requirements and its related complications.</p>

scholarly journals Assessment the role of tranexamic acid in prevention of postpartum hemorrhage

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Nevein Gerges Fahmy ◽  
Fahmy Saad Latif Eskandar ◽  
Walid Albasuony Mohammed Ahmed Khalil ◽  
Mohammed Ibrahim Ibrahim Sobhy ◽  
Amin Mohammed Al Ansary Amin
Keyword(s):  
Blood Loss ◽  
Cesarean Section ◽  
Tranexamic Acid ◽  
Postpartum Hemorrhage ◽  
Postoperative Bleeding ◽  
Control Group ◽  
Study Group ◽  
Mortality And Morbidity ◽  
Lower Segment Cesarean Section ◽  
Prophylactic Use

Abstract Background Postpartum hemorrhage (PPH) is one of the leading causes of maternal mortality and morbidity worldwide. It is believed that hemostatic imbalance secondary to release of tissue plasminogen activator (tPA) and subsequent hyperfibrinolysis plays a major role in PPH pathogenesis. Antifibrinolytic drugs such as tranexamic acid (TXA) are widely used in hemorrhagic conditions associated with hyperfibrinolysis. TXA reduced maternal death due to PPH and its use as a part of PPH treatment is recommended, and in recent years, a number of trials have investigated the efficacy of prophylactic use of TXA in reducing the incidence and the severity of PPH. The study is aiming to assess the efficacy of tranexamic acid in reducing blood loss throughout and after the lower segment cesarean section and reducing the risk of postpartum hemorrhage. Results The amount of blood loss was significantly lower in the study group than the control group (416.12±89.95 and 688.68±134.77 respectively). Also the 24-h postoperative hemoglobin was significantly higher in the study group (11.66±0.79 mg/dl) compared to the control group (10.53±1.07mg/dl), and the 24-h postoperative hematocrit value was significantly higher in the study group (34.99±2.40) compared to control (31.62±3.22). Conclusion Prophylactic administration of tranexamic acid reduces intraoperative and postoperative bleeding in cesarean section and the incidence of postpartum hemorrhage.

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.

Effect of Multiple Doses of Oral Tranexamic Acid on Haemostasis and Inflammatory Reaction in Total Hip Arthroplasty: A Randomized Controlled Trial

2018 ◽  
Vol 119 (01) ◽  
pp. 092-103 ◽  
Author(s):  
Duan Wang ◽  
Yang Yang ◽  
Chuan He ◽  
Ze-Yu Luo ◽  
Fu-Xing Pei ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Blood Loss ◽  
Inflammatory Response ◽  
Tranexamic Acid ◽  
Hip Arthroplasty ◽  
Multiple Dose ◽  
Control Group ◽  
Total Hip ◽  
Estimated Blood Loss ◽  
Significant Difference

AbstractTranexamic acid (TXA) reduces surgical blood loss and alleviates inflammatory response in total hip arthroplasty. However, studies have not identified an optimal regimen. The objective of this study was to identify the most effective regimen of multiple-dose oral TXA in achieving maximum reduction of blood loss and inflammatory response based on pharmacokinetic recommendations. We prospectively studied four multiple-dose regimens (60 patients each) with control group (group A: matching placebo). The four multiple-dose regimens included: 2-g oral TXA 2 hours pre-operatively followed by 1-g oral TXA 3 hours post-operatively (group B), 2-g oral TXA followed by 1-g oral TXA 3 and 7 hours post-operatively (group C), 2-g oral TXA followed by 1-g oral TXA 3, 7 and 11 hours post-operatively (group D) and 2-g oral TXA followed by 1-g oral TXA 3, 7, 11 and 15 hours post-operatively (group E). The primary endpoint was estimated blood loss on post-operative day (POD) 3. Secondary endpoints were thromboelastographic parameters, inflammatory components, function recovery and adverse events. Groups D and E had significantly less blood loss on POD 3, with no significant difference between the two groups. Group E had the most prolonged haemostatic effect, and all thromboelastographic parameters remained within normal ranges. Group E had the lowest levels of inflammatory cytokines and the greatest range of motion. No thromboembolic complications were observed. The post-operative four-dose regimen brings about maximum efficacy in reducing blood loss, alleviating inflammatory response and improving analgaesia and immediate recovery.

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 Perioperative tranexamic acid in day-case paediatric tonsillectomy

2014 ◽  
Vol 96 (2) ◽  
pp. 127-129 ◽  
Author(s):  
PJ Robb ◽  
G Thorning
Keyword(s):  
Blood Loss ◽  
Tranexamic Acid ◽  
Controlled Trial ◽  
Day Surgery ◽  
Minor Bleeding ◽  
Ventilation Tubes ◽  
American Society ◽  
Randomised Controlled ◽  
The Uk ◽  
Clinical Records

Introduction Tranexamic acid has been used for many years to minimise blood loss during surgery and, more recently, to reduce morbidity after major trauma. While small studies have confirmed reduction in blood loss during tonsillectomy with its use, the rate of primary haemorrhage following tonsillectomy has not been reported. In the UK, less than 50% of children having a tonsillectomy are managed as day cases, partly because of concerns about bleeding during the initial 24 hours following surgery. Methods A retrospective review of clinical records between January 2007 and January 2013 produced 476 children between the ages of 3 and 16 years who underwent Coblation™ tonsillectomy, with or without adenoidectomy and/or insertion of ventilation tubes. All children were ASA (American Society of Anesthesiologists) grade 1 or 2 and anaesthetised using a standard day surgery protocol. Following induction of anaesthesia, all received intravenous tranexamic acid at a dose of 10–15mg/kg. Results Two children (0.4%) had minor bleeding within two hours of surgery. Both returned to theatre for haemostasis and were discharged home later the same day with no further complications. The expected rate for primary haemorrhage in the UK using this technique for tonsillectomy is 1%. Conclusions Perioperative tranexamic acid in a single, parenteral dose might reduce the incidence of primary haemorrhage following paediatric tonsillectomy, facilitating discharge on the day of surgery. The results from this observational study indicate a potential benefit and need for a large, prospective, multicentre, randomised controlled trial.

scholarly journals Tranexamic acid in prevention of postpartum hemorrhage in elective cesarean section

2019 ◽  
Vol 8 (2) ◽  
pp. 372
Author(s):  
Pravin Shah ◽  
Ajay Agrawal ◽  
Shailaja Chhetri ◽  
Pappu Rijal ◽  
Nisha K. Bhatta
Keyword(s):  
Blood Loss ◽  
Cesarean Section ◽  
Tranexamic Acid ◽  
Postpartum Hemorrhage ◽  
Elective Cesarean Section ◽  
Controlled Study ◽  
Control Group ◽  
Estimated Blood Loss ◽  
Elective Cesarean ◽  
The Mean

Background: Postpartum hemorrhage is a common and occasionally life-threatening complication of labor. Cesarean section is associated with more blood loss in compared to vaginal delivery. Despite, there is a trend for increasing cesarean section rates in both developed and developing countries thereby increasing the risk of morbidity and mortality, especially among anemic women. The objective of this study was to evaluate the effect of preoperative administration of intravenous Tranexamic acid on blood loss during and after elective cesarean section.Methods: This was a prospective, randomized controlled study with 160 eligible pregnant women of 37 or more period of gestation. They were all planned for elective cesarean section and were randomized into two groups either to receive 10ml (1gm) of Tranexamic acid intravenously or 10ml of normal saline. Blood loss was measured during and for 24 hours after operation.Results: The mean estimated blood loss was significantly lower in women treated with Tranexamic acid compared with women in the placebo group (392.13 ml±10.06 vs 498.69 ml±15.87, respectively; p<0.001). The mean difference in pre-operative and post-operative hemoglobin levels was statistically significant in the Tranexamic acid group than in the control group (0.31±0.18 vs 0.79±0.23, respectively; p<0.001).Conclusions: Pre-operative use of Tranexamic acid is associated with reduced blood loss during and after elective cesarean section. In a developing country like ours where postpartum hemorrhage is a major threat to the life of the mothers, it seems to be a promising option.

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.

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