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1
Tikhilov, R. M., I. I. Shubnyakov, M. I. Mokhanna, et al. "Efficacy of Tranexamic Acid Application for Blood Loss Reduction in Total Hip Arthroplasty." N.N. Priorov Journal of Traumatology and Orthopedics 17, no. 1 (2010): 29–34. http://dx.doi.org/10.17816/vto201017129-34.
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Prospective study of tranexamic acid use results (native preparation Tranexam) in primary total hip arthroplasty was performed during the period from March to October 2009. The study involved 159 patients (55 men, 104 women) with various hip joint pathology (79 patients - main group, 80 patients - control group). Mean age of patients made up 55.7 years (17 - 80 years). In patients from the main group 15 mg/kg Tranexam was injected just prior to operation with reinjection of the same dose in 6 hours. In control group etamsylate (750 mg 30 minutes prior to incision with reintroduction in 4 - 6 hours, daily dose up to 1500 mg) was applied. The results of the analysis showed reliable (p
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Goloshchapov, Evgenii T., and Georgiy B. Lukichev. "Peculiarities of hemostasis in transurethral resection of prostatic gland using fybrinolysis inhibitor." Urology reports (St. - Petersburg) 1, no. 1 (2021): 27–29. http://dx.doi.org/10.17816/uroved57654.
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Tissue plasminogen activator being the most important component part of fybrinolysis is producing and accumulating in the prostatic gland. In surgical treatment of prostate an increased bleeding often occurs during the surgical operations on the prostate during as well as in post-operative period. General and local fybrino- lysis increase is in case among the reasons of haemor-ragy as a result of mechanical action on prostatic gland tissue in the process of an operation. It is suggested the use of Tranexam a tranexamic acid drug to neutralize an increasing fybrinolysis. In 83 patients with benign prostate hyperplasia, which underwent by transurethral resection of prostate, significantly positive effect of Tranexam was found, prescribed in therapeutic doses before operation, during operation and in early postoperative period.
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Pyrohova, V. I., and O. O. Oshurkevich. "Antifibrinolytic therapy in the clinic for miscarriage – aspects of medical tactics." HEALTH OF WOMAN, no. 4(120) (May 30, 2017): 78–82. http://dx.doi.org/10.15574/hw.2017.120.78.
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The objective: to evaluate the efficacy of tranexamic acid (Tranexam drug) accompanied by pregnancy with a partial detachment of a normally located placenta in the second trimester of pregnancy in women with a history of obstetrical gynecological anamnesis. Patients and methods. Under observation were 75 patients with complicated retrochorial hematoma at first trimester of pregnancy, re-hospitalized at the time of 18–21 weeks with signs of premature placental abruption. The blind method of the patient was randomized into two groups (baseline and comparison), which differed in the type of haemostatic therapy. Clinical groups were formed by age (26.5±0.8 and 27.4±1.1 years, respectively), parity, gestational age, somatic and obstetric-gynecological history, localization and approximate sizes of retroplacental hematomas were comparable. Patients from both groups received sublingual micronized progesterone at a dose of 200 mg, anti-anemia and symptomatic therapy according to indications. In the main group, 45 pregnant women received a haemostatic therapy with the drug Tranexam (Stada): 750 mg at a single dose at a single dose of 1500 mg for 5 to 7 days before bleeding stopped. 30 patients, who underwent haemostatic therapy with sodium etamzilate in a complex of therapeutic measures, made a comparison group. The duration of hemorrhage from the genital tract, the regression of the retrohorial hematoma, the length of stay in the hospital, the prolongation and the consequences of pregnancy were estimated. Results. Clinically, a decrease in the intensity of bleeding with Tranexam was observed 24.6±2.1 hours after the initial dose, bleeding duration averaged 3.5±0.3 days, whereas in the group taking sodium etamzilate, the bleeding time was significantly longer – 4.9±0.2 days (p<0.05). These data correlated with ultrasound data confirming the absence of progression of retrochorial hematomas from the second day with the use of Tranexam in 34 (75.6%) of the women in the main group, whereas in the comparison group, similar changes occurred at the same time in only 10 (33.3%) of patients (p<0.5). The faster stopping of bleeding and, as a consequence, the organization and resorption of hematomas in the region of placental detachment in a shorter period affected the effects of pregnancy (the frequency of preterm labor in the comparison group occurred 2.2 times more often than in the main group). Conclusion. Taking into account the peculiarities of the physiological mechanisms of the functioning of the fibrinolytic system during the gestation period and the significance of their disturbances in the genesis of early and late gestational bleeding allows us to choose the most effective therapeutic tactics. Tranexam in effective daily doses with course duration of treatment of 5–7 days gives a pronounced haemostatic effect, does not cause side effects, and allows successfully prolonging the pregnancy and reducing the frequency of late gestational complications. Inclusion in the treatment complex of patients with recurrence of retroplacentar hematomas and formation of partial placental detachment in the second trimester of gestation of the preparation of antifibrinolytic action to Tranexam is an effective means not only to stop bleeding, but also to preserve pregnancy, prevent the formation of placental insufficiency and ensure favorable pregnancy outcomes. Accumulated experience allows attributing Tranexam to the drugs of the first choice in the clinic for miscarriage and recommending it for widespread use in practice. Key words: retroplacentar hematoma, pregnancy, antifibrinolytic therapy, Tranexam.
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Vlasov, S. V., and A. A. Pronskikh. "Use of Tranexamic Acid at Knee Joint Arthroplasty." N.N. Priorov Journal of Traumatology and Orthopedics 19, no. 3 (2012): 64–69. http://dx.doi.org/10.17816/vto20120364-69.
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Results of comparative study of the efficacy and safety of intraoperative application of tranexam versus autoplasma in patients with planned surgical blood loss and high risk of venous thrombosis development has been presented. One hundred seven patients admitted for total knee replacement were divided into 2 groups. In the main group (55 patients) intraoperative intravenous infusion of 10 mg/kg tranexam were used. In the control group (52 patients) intraoperative hemodilution with autoplasma was performed. Hemostasis indices (APTT, INR, SFMC, D- dimer) and lysis index were studied before surgery and in postoperative period. Ultrasound scanning of lower extremity veins was performed before surgery and in 4—5 days after intervention. The volume of intraoperative blood loss in two groups did not differ. In the postoperative period the drainage blood loss in the main group was more than twice lower as compared to the control group (p=0,037). In postoperative period statistically significant increase in SFMC and D-dimer indices was noted in both groups. However after tranexam application the increase in fibrin lysis products content was reliably less marked than in control group. US investigation of lower extremities showed distal veins thrombosis in 2 patients from control group and no cases of thrombosis in the main group.
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Goloshchapov, Yevgeniy Tikhonovich, Georgiy Borisovich Lukichev, Yevgeniy Stanislavovich Nevirovich, Igor Valentinovich Kuzmin, and Yuriy Anatolyevich Ignashov. "Evaluating the effectiveness of Tranexam by transurethral resection of the prostate in patients with BPH." Urologicheskie vedomosti 2, no. 4 (2012): 16. http://dx.doi.org/10.17816/uroved2416-19.
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Lomonosov, A. L., A. A. Golubev, M. A. Kukanova, A. A. Khomenchuk, A. H. Khushakov, and G. D. Lomonosov. "Diagnosis and treatment of external hemorrhoids on an outpatient basis." Clinical Medicine (Russian Journal) 101, no. 6 (2023): 301–7. http://dx.doi.org/10.30629/0023-2149-2023-101-6-301-307.
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There are many variants of acute external hemorrhoids (AEH), with varying degrees of its development. The purpose of the study is to study the features of diagnosis and treatment of outpatient patients with AEH in the form of ovoid (AEH–FO). Material and methods. A solid sample, a retrospective sequential study of the data of 97 outpatient patients with AEH–FO. AEH–FO of the first degree (AEH–FO 1) was detected in 57,7% of patients, the node was more often elastic, blue in color, AEH–FO of the second degree (AEH–FO 2) in 42,3% of patients, wound necrosis on the node, the discharge of blood from it. In 32,7% of patients treated on average after 4 days, the average pain on the visual pain scale (VPS) was 6 points. Conservative treatment was carried out in all patients with AEH–FO with the appointment of MOFF (90% diosmin and 10% hesparin flavides. When bleeding from the node, tranexam, psyllium, lactulose, macrogol were prescribed for constipation. Analgesia was performed depending on the intensity of the pain. Only 3,1% of patients were operated on before 2018. Conclusions. The treatment of patients with AEH–FO was effective. In the average treatment period of 14 days, all patients recovered and were able to work.
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E.N.Imamov and E.R.Bekmirzaev. "CAUSES AND PREVENTION OF EARLY POST-PREGNANT BLEEDING." EURASIAN JOURNAL OF MEDICAL AND NATURAL SCIENCES 2, no. 4 (2022): 60–63. https://doi.org/10.5281/zenodo.6506666.
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Obstetric hemorrhages are among the top three causes of maternal death. At the same time, early postpartum hemorrhage occurring in the first 24 hours after birth accounts for a quarter of all maternal deaths worldwide. Changes in the blood coagulation system during pregnancy consist in a constant decrease in fibrinolytic activity and an increase in blood coagulation. These changes have a pronounced adaptive character and are aimed primarily at reducing the volume of physiological blood loss during childbirth. The article discusses the most common causes and risk factors for postpartum hemorrhage. The possibilities of treatment of postpartum hemorrhage are presented. The prophylactic use of tranexamic acid in patients at risk is recommended. Tranexamic acid is an antifibrinolytic agent. It has a local and systemic hemostatic effect in bleeding associated with an increase in fibrinolysis. The review presents current literature data on the possibilities of using tranexamic acid. It has been shown that the use of tranexamic acid reduces mortality among women with bleeding in the early postpartum period, regardless of the mode of delivery and without increasing the risk of thromboembolic complications. Some authors suggest a possible routine use of the drug in order to prevent increased blood loss in childbirth during caesarean section, which is especially important in risk groups for the development of bleeding.
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Arzhakova, Nadezhda Ivanovna, A. I. Bernakevich, E. V. Shushpanova, N. I. Arzhakova, A. I. Bernakevich, and E. V. Shushpanova. "Blood Saving Effect of Tranexame at Hip Joint Replacement." N.N. Priorov Journal of Traumatology and Orthopedics 16, no. 4 (2009): 13–18. http://dx.doi.org/10.17816/vto200916413-18.
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Study of the efficacy (by the results of blood saving action assessment) and application safety of tranexamic acid (home antifibrinolytic drug Tranexame) at hip arthroplasty was performed. Perioperative blood loss (intraoperative + postoperative blood loss by drainages during 24 hours), need in hemotransfusion, laboratory indices (hemoglobin, hematocrit, coagulograms) before and after operation were analyzed in 43 patients. Twenty patients received 4 g of Tranexame daily (main group) and 23 patients did not receive antifibrinolytic drugs. In the main group reliable decrease in blood loss as compared with control perioperative one, lower decrease of hemoglobin level and less need for donor plasma transfusion (in combination with autodonor blood and other blood savings methods) was noted. Safety of the drug was proved by the absence of thrombosis signs at ultrasonography of lower extremities vessels.
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Fedorova, T. A., R. G. Shmakov, O. V. Rogachevskiy, et al. "Patient’s blood management in obstetric practice with placenta accrete." Medical Council, no. 7 (April 5, 2019): 134–41. http://dx.doi.org/10.21518/2079-701x-2019-7-134-141.
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Placenta accreta is one of the most severe anomalies of attachment, due to the high risk of massive bleeding. At present, the paradigm of organ-preserving delivery is laid. The implementation of this tactic is possible in the context of the introduction into the obstetric practice of patient blood management (PBM).Objective:to evaluate the effectiveness of blood preservation methods in the management and delivery of pregnant women with placenta placenta accrete.Materials and methods:The study group consisted of 59 pregnant women with placenta accreta in age from 20 to 40 years old (32,43 ± 5,05), who were examined in «Scientific Medical Research Center of Obstetrics”. Clinical, special (ultrasound and magnetic pelvic magnetic resonance imaging) and laboratory methods were used. A program of preparation for delivery was developed using the principles of the PBM: treating anemia at the preoperative stage; a multidisciplinary operating team was prepared (two obstetricians, a surgeon, anesthesiologist and resuscitator, anesthetist, transfusionist, physician, who provides work for Cell Saver, laboratory assistant). Operational tactics included a bottom cesarean section using one of the methods of surgical prevention and arrest of bleeding - bilateral ligation of the internal iliac arteries (1st group) (19 women), temporary stop of blood flow in common iliac artery by means of vascular clamps Satinsky (18 patients – 2ndgroup); bilateral overlay of turnstile harnesses on the base of the wide ligaments and the cervical-neck area, supplemented by a controlled balloon tamponade of the uterus (22 patients – 3rd d group). The operation was carried out under conditions of intraoperative reinfusion of autoerythrocytes on the apparatus “Cell-Saver 5”, donor FFP and erythrocyte component, tranexam preparations, rFVIIa (KoagilVII) were administered. In 80% of women, operations were performed under combined spinal-epidural anesthesia.Results:the lowest blood loss was detected in the 3rd group with compression complex hemostasis: 1286 ± 510 ml. Accordingly, the volumes of infusion and transfusion therapy were also the smallest in this group. The volume of reinfused autoerythrocytes ranged from 260 ml to 1420 ml and averaged 801,7 ± 414,18 ml with a hematocrit of 55-60%. Donor erythrocytes were transfused to only 27 patients in an average volume of 785,1 ± 134,2 ml. rFVIIa (Koagil) was administered to four patients: three from the first group and one from the second group: a significant decrease in the speed and volume of bleeding was noted, and he performed an organ-sparing operation. Hysterectomy was performed on five women (8,77%). In the postoperative period was carried out antianemic therapy. The hospital stay averaged 7,9 ± 1,8 days.Conclusion:The special role in the management and delivery of pregnant with placenta accreta plays the use of various PBM techniques , which include rational therapy of preoperative and postoperative anemia with modern iron preparations, rational surgical tactics, red blood cell autotransfusion, use of modern hemostatic agents and blood substitutes. A comprehensive multidisciplinary approach to this problem allows reducing blood loss, minimizing the volume of donor blood components and implementing organ-preserving tactics in a significant number of women.
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Masood, Javeria, Zartaj Hayat, Nadia Ahmed, Robina Jabeen, Nazish Shifa, and Faiza Masud. "Comparison of Estimated Blood Loss between Tranexamic Acid and Control in Women Undergoing Elective Cesarean Section." Pakistan Journal of Medical and Health Sciences 17, no. 4 (2023): 288–90. http://dx.doi.org/10.53350/pjmhs2023174288.
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Background: Tranexamic acid is being utilized related to uterotonic agents to treat hemorrhage post-delivery. Evidence suggests that tranexamic acid may reduce bleeding and resultant chances of postpartum hemorrhage. However, limited data is available on the prophylactic utilization of tranexamic acid in local women undergoing elective lower segment cesarean section. This study aimed to compare reduction in mean blood loss between control and tranexamic acid group during and after elective lower segment cesarean section. Methodology: This randomized controlled trial was done in a period of 6 months i.e. 17th December 2018 to 17th June 2019 in the Department of Gynecology and Obstetrics, FUI, Fauji Foundation Hospital, Rawalpindi. Sixty women were randomly equally allocated to Group A (tranexamic acid) and Group B (non-tranexamic acid). Patients were given tranexamic acid 1gm intravenous 15 minutes before skin incision. Hemoglobin and hematocrit levels were estimated on second post cesarean day (before discharge) as well to measure outcome i.e. estimated blood loss. Results: In tranexamic acid group, mean estimated blood loss following elective lower segment cesarean section found to be 301.66±64.97 ml while in non-tranexamic acid group it was 433.33±137.29 ml. The significant (P<0.05) difference was noted. Conclusion: The mean estimated blood loss reduced significantly in patients who were given tranexamic acid before elective lower segment cesarean section than those who were not given tranexamic acid. Keywords: Postpartum hemorrhage, tranexamic acid, elective lower segment cesarean section (E:-LSCS)
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Clay, T. Bradly, A. Sayo Lawal, Thomas W. Wright, et al. "Tranexamic acid use is associated with lower transfusion rates in shoulder arthroplasty patients with preoperative anaemia." Shoulder & Elbow 12, no. 1_suppl (2019): 61–69. http://dx.doi.org/10.1177/1758573219841058.
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Background We evaluate tranexamic acid use in high-risk shoulder arthroplasty patients, hypothesizing that tranexamic acid will decrease transfusion rates in patients with low preoperative haematocrit. Methods A retrospective review of shoulder arthroplasty patients with preoperative anaemia compared those treated with and without perioperative tranexamic acid. Inclusion criterion was any shoulder arthroplasty with a preoperative haematocrit (Hct) <38%. Tranexamic acid was given generally as 1 g intravenously before incision and 1 g during wound closure; topical tranexamic acid was used in cases of contraindication to IV tranexamic acid. Preoperative Hct, postoperative Hct, estimated blood loss, preoperative anticoagulation use, American Society of Anesthesiologist score, transfusion rate and demographic data were compared between groups with and without tranexamic acid. Results Of the 435 arthroplasties performed, 109 patients had preoperative Hct < 38% (haemoglobin of 12.7 g/dL); 69 had tranexamic acid perioperatively and 40 did not. Demographics, anticoagulation use, diagnosis, arthroplasty types, estimated blood loss and preoperative Hct were similar between groups. The tranexamic acid group had a higher postoperative Hct, significantly lower transfusion rate and significantly smaller drop in Hct. Hct levels, Hct change and transfusion rate for topical versus intravenous tranexamic acid were not significantly different. Discussion Perioperative tranexamic acid in high-risk shoulder arthroplasty patients with preoperative Hct <38% is associated with higher postoperative Hct and lower transfusion rates.
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Essien UE, Inyang UC, Itakpe SE, Lawal WO, Dim EM, and Usendiah IB. "Efficacy of oral Tranexamic Acid in reducing blood loss during primary total hip arthroplasty: A comparative study." Ibom Medical Journal 16, no. 2 (2023): 148–53. http://dx.doi.org/10.61386/imj.v16i2.311.
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Background: Perioperative blood loss is a major concern for patients undergoing total hip arthroplasty. Intravenous Tranexamic acid is commonly used to reduce blood loss and need for blood transfusion following total hip replacement. Recent studies have shown the efficacy of oral tranexamic acid in reducing perioperative blood loss in total hip replacement.
 Method: A total of 69 patients undergoing primary total hip replacement in National Orthopaedic Hospital, Igbobi, Lagos, were recruited. Patients were randomized to receive 2gram oral tranexamic acid 2hours before incision or 1-gram intravenous tranexamic acid 10minutes before incision. Primary outcome measure was reduction in haemoglobin concentration.
 Results: There was no significant difference in mean reduction in haemoglobin concentration in the oral tranexamic acid group compared to intravenous tranexamic acid group (3.78g/dl ±1.27 and 3.61g/dl ±0.54 respectively, P- 0.49). There was no significant difference between total blood loss and requirement for blood transfusion in the two groups.
 Conclusion: Oral and intravenous routes of tranexamic acid administration have comparable efficacy in reducing blood loss and requirement for blood transfusion. Oral tranexamic acid is cheaper, easier to administer and should be considered as a safe and effective alternative to intravenous tranexamic acid.
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Jinliang, Wang, and Wei Xuan. "Effect of tranexamic acid on the timing of drainage tube removal in total knee arthroplasty." Orthopaedic Journal of Sports Medicine 8, no. 9_suppl7 (2020): 2325967120S0052. http://dx.doi.org/10.1177/2325967120s00525.
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Introduction: To investigate the effect of tranexamic acid on the removal time of drainage tube in the first unilateral total knee arthroplasty. Hypotheses: The timing of removing the drinage system can be changed when using TXA. Methods: From June 2017 to December 2018, 182 patients (42 males and 140 females) who planned to undergo primary unilateral total knee replacement were included.Age (68.1±7.1) years (60-76 years).According to the random number table method, it was divided into four groups: 45 cases of Tranexamic acid group 1 (TXA1), 46 cases of Tranexamic acid group 2 (TXA2), 46 cases of Tranexamic acid group 3 (TXA3) and None Tranexamic acid group (NTXA).TXA1-3 group intraoperative intravenous infusion combined with local application of tranexamic acid;NTXA group was locally perfused in the joint cavity with 100ml normal saline only after surgery.Differences in drainage volume, total blood loss, invisible blood loss, degree of postoperative joint swelling, Hospital for special surgery (HSS) and visual analogue scale (VAS) of pain were compared among the four groups. Results: The postoperative drainage volume of TXA1˜3 groups was 85.5±34.3ml, 189.4±72.3ml and 215.3±93.4ml, respectively, which was less than that of the non-tranexamic acid group (351.3±113.5ml). The overall difference was statistically significant (F=11.5,P=0.005). The postoperative drainage volume of tranexamic acid 1 group was less than that of tranexamic acid 2 and 3 groups.The total postoperative blood loss was 699.0±255.7ml, 710.4±296.1ml, and 715.8±248.2ml in the tranexamic acid 1-3 groups, respectively, which was less than 1130.5±354.2ml in the non-tranexamic acid group, and the overall difference was statistically significant (F=13.1,P=0.001).On the 4th day after the operation, the knee swelling degree of the tranexamic acid 1- 3 groups was 1.25±0.07, 1.13±0.12, and 1.12±0.13, respectively, which were smaller than that of the non-tranexamic acid group (1.43±0.22), and the overall difference was statistically significant (F=8.23, P=0.015).There were 2 cases of positive bacterial culture in non-tranexamic acid group and tranexamic acid group.There were 3 cases of hematoma in the non-tranexamic acid group,and 1 case of delayed wound healing. Conclusion: The application of tranexamic acid after TKA can reduce postoperative drainage volume, latent blood loss and total blood loss.The removal of the drainage tube 18h after the operation can not only fully drain,relieve pain, promote the recovery of knee joint function, but also effectively reduce the risk of infection caused by the drainage tube.
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Moran, N. F., D. G. Bishop, S. Fawcus, et al. "Tranexamic Acid at Cesarean Delivery: Drug-error Deaths." Obstetric Anesthesia Digest 43, no. 4 (2023): 166–67. http://dx.doi.org/10.1097/01.aoa.0000990292.62353.a6.
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(Am J Obstet Gynecol. 2023;228:1–4) Tranexamic acid plays an important role in reducing bleeding experienced during postpartum hemorrhage. It is recommended by the World Health Organization that tranexamic acid is administered intravenously, over 10 minutes, within 3 hours of delivery to treat postpartum hemorrhage. However, tranexamic acid, although helpful in cases of postpartum hemorrhage, has caused other problems to arise. It has been found that tranexamic acid is toxic when administered intrathecally (IT). Tranexamic acid has components that are known to lead to neuronal excitation when mistakenly administered in the intrathecal space. This most often leads to generalized convulsions and malignant arrhythmias. This has been occurring more frequently secondary to tranexamic acid being stored in labor and delivery operating rooms on anesthetic drug carts for easy access for hemorrhage during cesarean delivery. Both tranexamic acid and the drugs used for spinal anesthesia are stored in look-alike glass vials making this risk even more likely. A review published in 2019 reported 21 cases of inadvertent intrathecal administration of tranexamic acid, 20 of these cases were life-threatening with ten resulting in patient deaths. The accidental administration of tranexamic acid intrathecally most likely occurs more often than it has been reported. The mistake of replacing spinal anesthesia drugs with tranexamic acid most commonly occurs in small hospitals and low-middle-income countries.
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Miyashita, Tetsuya, Takahiko Kamibayashi, Yoshihiko Ohnishi, Junjiro Kobayashi, and Masakazu Kuro. "Preservation of collagen-induced whole blood platelet aggregation by tranexamic acid therapy in primary cardiac valve surgery." Perfusion 15, no. 6 (2000): 507–13. http://dx.doi.org/10.1177/026765910001500606.
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Haemostatic disorder is one of the most common complications following cardiac surgery with cardiopulmonary bypass (CPB). Tranexamic acid reduces blood loss and allogeneic blood transfusion requirement in cardiac surgery. It had been thought that tranexamic acid inhibited fibrinolysis alone following CPB. In the present study, the haemostatic effects of tranexamic acid (20 mg/kg body weight bolus after induction of anaesthesia followed by continuous infusion at 2 mg/kg/h), including fibrinolysis and platelet function, were investigated in 22 patients (tranexamic acid group n = 12; control group n = 10) undergoing primary cardiac valve surgery. Fibrinolysis following CPB was reduced significantly in the tranexamic acid group. Following protamine administration, the reduction of collagen-induced whole blood platelet aggregation was mitigated significantly in the tranexamic acid group compared with the control group (36% reduction in the tranexamic acid group vs 58% in the control group; p = 0.011), although platelet counts did not differ between the two groups. In conclusion, tranexamic acid not only inhibits fibrinolysis directly, but also may preserve platelet function following CPB.
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Townsley, M. I., S. A. Barman, and A. E. Taylor. "Pulmonary embolism: emboli and fibrinolysis inhibition in isolated canine lungs." American Journal of Physiology-Heart and Circulatory Physiology 258, no. 3 (1990): H754—H758. http://dx.doi.org/10.1152/ajpheart.1990.258.3.h754.
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The effect of fibrinolysis inhibition with tranexamic acid on pulmonary microvascular permeability during glass bead embolization was investigated in the isolated lung. Lung lobes from nonheparinized dogs were treated in vivo with the equivalent of 0.6 g/kg 100 microns glass bead emboli alone, emboli after tranexamic acid, tranexamic acid alone, or the bead vehicle alone. After 40-50 min, the lobes were isolated for ex vivo perfusion with heparinized autologous blood. There were no changes in any parameter over the 120-min perfusion period. Blood flow at 120 min was decreased after both emboli alone and emboli with tranexamic acid, reflecting an increase in vascular resistance compared with the Tween or tranexamic acid controls. Furthermore, tranexamic acid increased the ratio of pre- to postcapillary resistance in embolized lobes compared with that after emboli alone or in the Tween or tranexamic acid controls. The isogravimetric capillary pressure and the osmotic reflection coefficient were not significantly decreased by tranexamic acid compared with those after emboli alone; however, it did result in an increase in the capillary filtration coefficient compared with that after emboli alone or in the control groups. We conclude that although fibrinolysis inhibition does not clearly exacerbate the lung injury seen after emboli, the tranexamic acid-induced changes in hemodynamics would tend to accelerate edema formation.
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Zhang, Feiyang, Wenjun Dong, Fengyan Wang, et al. "The Topical Tranexamic Acid Have Potential Hazard of Promoting Biofilm Formation of Staphylococcus aureus in Microenvironment of the Prosthetic Joint." BioMed Research International 2021 (March 11, 2021): 1–8. http://dx.doi.org/10.1155/2021/5748069.
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Background. Perioperative topical tranexamic acid as antifibrinolytic agent is often used for total joint replacement to reduce bleeding currently. Staphylococcus aureus was the most common isolates from perioperative infection of prosthetic joint. The influence of topical application with tranexamic acid on the incidence of acute prosthetic joint infection of Staphylococcus aureus has not been clarified. Methods. Mouse model of Staphylococcus aureus knee prosthesis infection was constructed. Tranexamic acid was intra-articular injected during the perioperative period. CFU counting from tissue and implant sample was evaluated 3 days and 7 days after inoculating of Staphylococcus aureus. Bacterial growth curve, biofilm formation, aggregation, and plasmin inhibition of Staphylococcus aureus were tested with tranexamic acid added to the synovial culture medium. Results. There were no significant differences of CFU counting from tissue and implant samples in knee prosthesis infection after a single local injection of tranexamic acid at the postoperative 3 or 7 days. The amount of bacterial colonization on the surface of implant increased after 3 days’ continuous local injection of tranexamic acid. Tranexamic acid has no effect on bacterial growth at the concentration (10 mg/ml) of clinical application, but it can inhibit bacterial aggregation and mildly inhibit biofilm formation. Plasmin can significantly inhibit biofilm formation which can be revised by adding tranexamic acid. Conclusion. Although continuous local injection of tranexamic acid can promote the biofilm formation of Staphylococcus aureus on the surface of articular implant, it has clinical safety for using one single local injection of tranexamic acid during the perioperative period.
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Luo, Hua, Chaojun Shen, Tongyou Qu, Lin Chen, Yue Sun, and Yu Ren. "Tranexamic acid-induced focal convulsions after spinal surgery: a rare case report and literature review on side effects of accidental spinal administration of tranexamic acid." EFORT Open Reviews 8, no. 6 (2023): 482–88. http://dx.doi.org/10.1530/eor-23-0016.
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Convulsions are a neurological illness that has complexity. In clinical treatment, drug-induced convulsions appear from time to time. Drug-induced convulsions often begin as isolated acute seizures but may progress to persistent seizures. In orthopedics, topical administration of tranexamic acid is commonly used in conjunction with intravenous drip to achieve hemostasis during artificial joint replacement surgery. However, side effects induced by tranexamic acid accidental spinal administration should be taken seriously. We report a case of a middle-aged male treated with tranexamic acid locally in combination with intravenous drip for intraoperative hemostasis when undergoing spinal surgery. The patient had involuntary convulsions in both lower limbs after the operation. After symptomatic administration, the symptoms of convulsions gradually resolved. During the follow-up, the convulsions never occurred again. We reviewed the literature on cases with side effects of local tranexamic acid application in spinal surgery and discussed the mechanism of tranexamic acid-induced convulsions. Tranexamic acid is associated with an increased incidence of postoperative seizures. However, many clinicians are unaware that tranexamic acid causes seizures. This rare case summarized the risk factors and clinical features of these seizures. Moreover, it highlights several clinical and preclinical studies that offer mechanistic insights into the potential causes and treatments for tranexamic acid-associated seizures. A clear understanding of tranexamic acid-induced convulsions-related adverse reactions can help the first-line clinical screening of causes and adjustment of drug treatment. This review will aid the medical community by increasing awareness about tranexamic acid-associated seizures and translating scientific findings into therapeutic interventions for patients.
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Minaei, Reza, Seyed Morteza Kazemi, Seyyed Mehdi Hoseini, Alireza Mirahmadi, Pooya Hosseini-Monfared, and Maryam Salimi. "Combined intravenous and intraarticular tranexamic acid compared with intraarticular use alone in total knee arthroplasty: A randomized controlled trial." Indian Journal of Orthopaedics Surgery 9, no. 3 (2023): 162–67. http://dx.doi.org/10.18231/j.ijos.2023.032.
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: Total knee arthroplasty is associated with high rates of blood loss during and after the surgery. Tranexamic acid is an antifibrinolytic agent that effectively reduces total blood loss in total knee arthroplasty and minimizes the need for blood transfusion and transfusion-related complications. However, the most efficacious route of tranexamic acid administration has not been established. Therefore, in this study, we aimed to compare combined intravenous and intraarticular tranexamic acid with intraarticular use alone in patients undergoing total knee arthroplasty.In this randomized, double-blind clinical trial, 104 patients scheduled for primary unilateral Total knee arthroplasty were randomized to one of the two intervention groups. The combined intravenous and intraarticular group received 15 mg/kg (Max dose of 1 g) of intravenous tranexamic acid along with 15 mg/kg (Max dose of 1 g) of tranexamic acid administered intraarticularly after the capsule and retinaculum closure. Total blood loss was calculated using the drop in hemoglobin at post-operative day 3. The transfusion rate and incidence of thromboembolic events were evaluated.Total blood loss in patients receiving combined intravenous and intraarticular tranexamic acid was not significantly different from that in patients receiving only intraarticular tranexamic acid (926 ± 312 ml vs 905 ± 348 ml, p value= 0.824). There were no complications like thromboembolic events or wound infection. In conclusion, the intraarticular administration of tranexamic acid is an equally effective route as combined intravenous and intraarticular use of tranexamic acid in total knee arthroplasty, and hence to avoid potential complications of systemic TXA use, we recommend using the intraarticular only tranexamic acid in total knee arthroplasty.
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Elfadli, Mustafa M. "Comparative Study of Reducing Blood Loss in Total Knee Replacement with and without the Use of Tranexamic Acid, Tourniquet, and Drainage." Journal of Medical Science and clinical Research 12, no. 07 (2024): 01–04. http://dx.doi.org/10.18535/jmscr/v12i07.01.
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Background: Patients who undergo total knee arthroplasty (TKA) may develop large blood loss. The intraoperative and postoperative blood loss after TKA ranges from 1500 to 1900 cc. TKA is often carried out using a tourniquet and drains to collect the shedded blood loss. However, tranexamic acid is found to decrease blood loss. Tranexamic acid is a fibrinolysis inhibitor that blocks the plasminogen, and it has been reported before that it reduces blood loss in patients undergoing TKA. However, few reports describe the effects of tranexamic acid on blood loss in patients who underwent TKA. Objectives: To study the reduction of blood loss after intravenous tranexamic acid infusion in patients undergoing TKA without the use of tourniquets or drains. Patients and Methods: We performed a total of 95 TKA in osteoarthritis patients between 2017-2018. A total of 30 patients were operated during 2017 and at that time tourniquets with drains were used with no intravenous tranexamic acid. On the other hand, a total of 45 patients were operated in the year 2018 and for those intravenous tranexamic acid was used to decrease the blood loss without the use of tourniquets or drains. For those who received tranexamic acid it was given as follows, at time of anesthesia induction a total of 1 gram tranexamic acid is infused over 10 min. At closure, another 1 gram tranexamic acid is infused over 10 min. Furthermore, Patient's demographics, preoperative and postoperative hemoglobin (Hb) levels were studied as well as the need for blood transfusion between the two groups. Results: The two groups had similar characteristics. The mean of pre and postoperative hemoglobin difference was 2.9 (SD 1.0) and 3.5 (SD 1.23) in the tourniquets and tranexamic acid groups respectively (p value = 0.041). However, postoperatively 5 (16.6%) of the tourniquets group received blood transfusion. Whereas, no one (0%) of the tranexamic acid patients needed to receive blood (p value = 0.005). Conclusion: The use of tranexamic acid may decrease the total blood loss in patients undergoing TKA. Furthermore, there is less need for blood transfusion in those who received tranexamic acid
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Liu, Fei, Dong Xu, Kefeng Zhang, and Jian Zhang. "Effects of tranexamic acid on coagulation indexes of patients undergoing heart valve replacement surgery under cardiopulmonary bypass." International Journal of Immunopathology and Pharmacology 29, no. 4 (2016): 753–58. http://dx.doi.org/10.1177/0394632016671142.
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This study aims to explore the effects of tranexamic acid on the coagulation indexes of patients undergoing heart valve replacement surgery under the condition of cardiopulmonary bypass (CPB). One hundred patients who conformed to the inclusive criteria were selected and divided into a tranexamic acid group and a non-tranexamic acid group. They all underwent heart valve replacement surgery under CPB. Patients in the tranexamic acid group were intravenously injected with 1 g of tranexamic acid (100 mL) at the time point after anesthesia induction and before skin incision and at the time point after the neutralization of heparin. Patients in the non-tranexamic acid group were given 100 mL of normal saline at corresponding time points, respectively. Then the coagulation indexes of the two groups were analyzed. The activated blood clotting time (ACT) of the two groups was within normal scope before CPB, while four coagulation indexes including prothrombin time (PT), activated partial thromboplastin time (APTT), international normalized ratio (INR), and fibrinogen (FIB) had significant increases after surgery; the PT and INR of the tranexamic acid group had a remarkable decline after surgery. All the findings suggest that the application of tranexamic acid in heart valve replacement surgery under CPB can effectively reduce intraoperative and postoperative blood loss.
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Moscote-Salazar, Luis Rafael, Amit Agrawal, Andres M. Rubiano, et al. "An international based survey on perioperative use of tranexamic acid in neurotrauma." Romanian Neurosurgery 30, no. 2 (2016): 248–51. http://dx.doi.org/10.1515/romneu-2016-0038.
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Abstract Background: Tranexamic acid is used to reduce bleeding, easy to use, affordable and relatively safe. There are few studies on the use of tranexamic acid in trauma and especially in neurosurgery. There is no published study on the trend the use of tranexamic acid in neurotrauma surgery among international doctors. The aim of this study was to evaluate the current practice for use of tranexamic acid during neurotrauma surgery. Materials and Methods: A 11-question electronic survey was sent to 25 practicing physicians worldwide. Basic demographic information and estimated rates of use of tranexamic acid during neurotrauma surgery. Results: Twenty five physicians responded to our survey. Very Few trusts (12%) use tranexamic acid during neurotraumasurgery. Conclusion: Further studies are required to establish guidelines in neurosurgery and neurotrauma, especially. The use of this medicine potentially helps improve patient care with head injury and save lives.
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Ravi, Gopala K., Nidhi Panda, Jasmina Ahluwalia, Rajeev Chauhan, Navneet Singla, and Shalvi Mahajan. "Effect of tranexamic acid on blood loss, coagulation profile, and quality of surgical field in intracranial meningioma resection: A prospective randomized, double-blind, placebo-controlled study." Surgical Neurology International 12 (June 7, 2021): 272. http://dx.doi.org/10.25259/sni_296_2021.
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Background: Resection of intracranial meningioma has been associated with significant blood loss. Providing a clear surgical field and maintaining hemodynamic stability are the major goals of anesthesia during meningioma surgery. Tranexamic acid has been used to reduce blood loss in various neurosurgical settings with limited evidence in literature. A randomized, double-blind, and placebo-controlled trial was conducted to evaluate the efficacy of tranexamic acid on blood loss, coagulation profile, and quality of surgical field during resection of intracranial meningioma. Methods: Thirty patients aged 18–65 years undergoing elective meningioma resection surgery were given either tranexamic acid or placebo (0.9% saline), tranexamic acid at a loading dose of 20 mg/kg, and infusion of 1 mg/kg/h during surgery. The intraoperative blood loss, coagulation profile, and the surgical field using Likert scale were assessed. Results: The patients in tranexamic group had significantly decreased intraoperative blood loss compared to the placebo group (616.42 ± 393.42 ml vs. 1150.02 ± 416.1 ml) (P = 0.02). The quality of the surgical field was better in the tranexamic group (median score 4 vs. 2 on Likert Scale) (P < 0.001). Patients in tranexamic group had an improved coagulation profile and decreased blood transfusion requirement (p=0.016). The blood collected in closed suction drain in 24 h postsurgery was less in the tranexamic acid group compared to placebo group (84.7 ± 50.4 ml vs. 127.6 ± 62.2 ml) (P = 0.047). Conclusion: Tranexamic acid bolus followed by infusion reduces perioperative blood loss by 46.43% and blood transfusion requirement with improved surgical field and coagulation profile in patients undergoing intracranial meningioma resection surgery.
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Utomo, Dwikora Novembri, Teddy Heri Wardhana, Ahmad Hannan Amrullah, and Hamzah Hamzah. "THE EFFECT OF TRANEXAMIC ACID INJECTION ON HEMOGLOBIN LEVEL, ALBUMIN LEVEL, AND PAIN ON PATIENT RECEIVING TOTAL KNEE REPLACEMENT." (JOINTS) Journal Orthopaedi and Traumatology Surabaya 8, no. 1 (2019): 1. http://dx.doi.org/10.20473/joints.v8i1.2019.1-11.
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Background: The high number of knee osteoarthritis cases could lead arthroplasty more frequent. Total Knee Replacement (TKR) surgery procedure is at risk of massive bleeding. Bleeding can affect albumin levels and the onset of intra-compartment pressure on the nerves. The use of tranexamic acid could be done to reduce bleeding.Objective: Proving the effect of intravenous tranexamic acid administration on patients who will undergo TKR surgery.Methods: The experiment was conducted experimentally using primary laboratory data obtained before and after surgery in patient which will be performed TKR operation starting from April 2017.Result: There are 64 patients who had undergone total knee replacement surgery. The mean preoperative hemoglobin in the tranexamic acid group and without tranexamic acid was 13.06±1.46g/dl and 12.44±0.87g/dl. The mean hemoglobin after surgery was 10.29 ±1.14 g/dl and 9.16±0.97 g/dl. In the group receiving tranexamic acid, 32 (100%) reported low postoperative VAS scores, did not require blood transfusions and did not require albumin transfusion. Groups not receiving tranexamic acid, 32 (100%) moderate postoperative VAS scores, 4 people (12.5%) required the blood transfusion, and 3 (9.4%) required transfusion of albumin.Conclusion: The results of this study showed that the group given tranexamic acid had higher hemoglobin levels after surgery than the untreated group of tranexamic acid; there was no difference in albumin levels after surgery in both groups; the administration of tranexamic acid will decrease the amount of blood loss, decrease the degree of pain, and decrease the need for blood transfusions after total knee replacement surgery.
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Hapsari, Rania Adeastri, and Tendy Novara. "Tranexamic acid-induced seizures in postpartum patients." International journal of health & medical sciences 7, no. 3 (2024): 53–58. http://dx.doi.org/10.21744/ijhms.v7n3.2288.
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Introduction: Tranexamic acid has found extensive application in obstetrics to prevent and treat postpartum hemorrhage (PPH). This case report investigated an infrequent incidence in which seizures were caused by the administration of tranexamic acid. Even though tranexamic acid is generally regarded as safe, it has been associated with the infrequent yet serious side effects of tranexamic acid-induced seizures. This case report was aimed at investigating the infrequent incidence of tranexamic acid-induced seizures in postpartum patients. Case: It was reported that a woman who was 40 weeks pregnant suffered from postpartum seizures after delivery via cesarean section. These seizures occurred after tranexamic acid was administered to treat postpartum hemorrhage (PPH) caused by uterine rupture, which was accompanied by hypocalcemia. Despite not having a history of epilepsy, preeclampsia, or hypertension, the electrocardiogram (EKG) showed a prolongation of the QT interval. A comprehensive diagnostic evaluation, which involved a CT scan of the head and a D-dimer examination, was conducted, revealing no abnormalities. Discussion: Tranexamic acid, a synthetic derivative of lysine, acts as a competitive inhibitor of plasminogen activation, thereby inhibiting the breakdown of fibrin clots.
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Nishat, Mufassar, Sohail Iqbal, Armaghan Ahmed, Shoaib Younas, Liaqat Ali Deokah, and Zakariya Rashid. "Clinical study of Evaluation of the Effect of Tranexamic Acid in Primary Cleft Palate Surgery in Children." Pakistan Journal of Medical and Health Sciences 15, no. 10 (2021): 2708–10. http://dx.doi.org/10.53350/pjmhs2115102708.
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Aim : To evaluate tranexamic acid effect on quality of surgery. Design: Double-blind study, Prospective and randomized Place & time of study: June 2020 to may 2021Allama iqbal memorial trust hospital Gujranwala. Methods: Two groups of candidates were made. The saline was administered to the control group whereas tranexamic acid was administered as 0.01g/kg in a bolus form, before surgical incision to tranexamic acid group. On a 10-point scale, grading of surgical field, primary hemorrhage and satisfaction of surgeon Results: As far as operating surgeon satisfaction is concerned, noteworthy improvement was witnessed and evaluation of surgery in case of control individuals group as compared to in case of test individual group in the tranexamic acid individuals group was estimated against the control members of group. Conclusion: tranexamic acid was given in dosage of 0.01g/kg of before surgical incision showed improved in a great way in surgical field during repairing of cleft palate operation. Keywords: tranexamic acid surgical field, pediatric, palatoplasty satisfaction, cleft palate
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Bogner, Elodie, Elodie Ferrero, Joelle Marin, and Stanislas Bataille. "Peritoneal dialysis catheter dysfunction due to fibrin clots following treatment with tranexamic acid: a clinical case." Bulletin de la Dialyse à Domicile 4, no. 2 (2021): 121–28. http://dx.doi.org/10.25796/bdd.v4i2.61393.
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Chronic kidney disease patients experience not only more frequent arterial and venous thrombosis but also hemorrhagic episodes. Tranexamic acid is an anti-fibrinolytic molecule that inhibits plasmin activation. It is used in hemorrhage cases (post-traumatic, gynecologic, or gastrointestinal bleeding).
 We report on an original case of tranexamic acid (Exacyl®) use in a peritoneal dialysis patient for gastrointestinal bleeding of unknown origin. The use of tranexamic acid led to the Tenckhoff catheter dysfunction because of fibrin clots in the dialysate.
 The emergence of fibrin clots a few days after the start of tranexamic acid treatment, which never occurred again after the end of the treatment, and the anti-fibrinolytic function of tranexamic acid favors this treatment’s role in fibrin clot occurrence.
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Vogt, Ashtyn Z., Pouriska B. Kivanany, Matthew A. De Niear, Ivan M. Vrcek, and Natalie A. Homer. "The Effect of Intravenous Tranexamic Acid on Postoperative Ecchymoses after Upper Blepharoplasty." Plastic and Reconstructive Surgery - Global Open 12, no. 8 (2024): e6089. http://dx.doi.org/10.1097/gox.0000000000006089.
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Background: Tranexamic acid has been increasingly used in facial plastic surgery to improve perioperative hemostasis. While subcutaneous tranexamic acid has been found to not significantly decrease postoperative ecchymoses following upper blepharoplasty, systemic administration has not previously been studied. Methods: A total of 325 patients undergoing upper blepharoplasty were randomly assigned to either receive intravenous tranexamic acid or serve as a control. Patients in the experimental group were administered 1 g of tranexamic acid intravenously 10 minutes before surgical incision. A similar upper blepharoplasty technique was performed by two American Society of Ophthalmic Plastic and Reconstructive Surgery-trained surgeons. Follow-up was conducted at a median of 8 days postsurgery. Patient photographs were evaluated by two independent graders to rate ecchymoses on a scale of 0 (least) to 10 (most). Results: Of the 325 included patients, 138 patients received intravenous tranexamic acid and 187 patients did not. The average ecchymosis rating for the control group at day 8 was 5.8 ± 1.7, while the average rating for the tranexamic acid group at the same time point was 4.1 ± 1.6 (P < 0.0001). There was a trend toward decreased ecchymoses in the tranexamic acid group at earlier and later postoperative timepoints that did not reach statistical significance. No hemorrhagic or systemic embolic complications occurred. Conclusions: Systemic tranexamic acid may reduce postoperative ecchymoses after upper blepharoplasty surgery, reaching significance at the eighth postoperative day, which may lead to improved patient satisfaction and decreased occupational downtime.
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Horrow, Jan C., Daniel F. Van Riper, Michael D. Strong, Karl E. Grunewald, and Jonathan L. Parmet. "The Dose-Response Relationship of Tranexamic Acid." Anesthesiology 82, no. 2 (1995): 383–92. http://dx.doi.org/10.1097/00000542-199502000-00009.
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Background Prophylactic administration of the antifibrinolytic drug tranexamic acid decreases bleeding and transfusions after cardiac operations. However, the best dose of tranexamic acid for this purpose remains unknown. This study explored the dose-response relationship of tranexamic acid for hemostatic efficacy after cardiac operation. Methods In prospective, randomized, double-blinded fashion, 148 patients undergoing cardiac operation with extracorporeal circulation were divided into six groups: a placebo group and five groups receiving tranexamic acid in loading doses before incision (range 2.5 to 40 mg.kg-1) and one-tenth the loading dose hourly for 12 h. The mass of blood collected by chest tubes over 12 h represented blood loss. Allogeneic transfusions within 12 h and within 5 d of surgery were tallied. Results The six groups presented similar demographics. Patients receiving placebo had increased postoperative D-dimer concentration compared to groups receiving tranexamic acid. Patients receiving at least 10 mg.kg-1 tranexamic acid followed by 1 mg.kg-1.h-1 bled significantly less (365, 344, and 369 g.12 h-1, respectively, for those three groups) compared with patients who received placebo (552 g, P &lt; 0.05). Tranexamic dose did not affect transfusions. Only initial hematocrit affected whether a patient received an allogeneic transfusion within 5 days of operation (odds ratio 2.08 for each 3% absolute decrease in hematocrit). Conclusions Prophylactic tranexamic acid, 10 mg.kg-1 followed by 1 mg.kg-1.h-1, decreases bleeding after extracorporeal circulation. Larger doses do not provide additional hemostatic benefit.
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Prakash, Jatin, Jong-Keun Seon, Yong Jin Park, Cheng Jin, and Eun-Kyoo Song. "A randomized control trial to evaluate the effectiveness of intravenous, intra-articular and topical wash regimes of tranexamic acid in primary total knee arthroplasty." Journal of Orthopaedic Surgery 25, no. 1 (2017): 230949901769352. http://dx.doi.org/10.1177/2309499017693529.
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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.
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Aziz, Bara’a Mahir, Islam Al-Talibi, Shalan Mufleh Darak, Ali Abdulmuttalib Mohammed, and Haitham Alnori. "Tranexamic acid versus adrenaline-soaked pledgets for the reduction of intraoperative bleeding in functional endoscopic sinus surgery." Polski Merkuriusz Lekarski 52, no. 1 (2024): 36–41. http://dx.doi.org/10.36740/merkur202401106.
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Aim: To examine the impact of locally applied tranexamic acid and adrenaline, separately and in combination, on intraoperative blood loss and surgical field quality during functional endoscopic sinus surgery. Materials and Methods: The study involved 40 patients with chronic rhinosinusitis. They were divided into two groups. Group I received adrenaline alone in one side and a mixture of adrenaline and tranexamic acid in the other side. Group II received adrenaline alone in one side and tranexamic acid in the otherside. Parameters like surgery time, blood loss, and surgical field quality were studied. Results: In Group I, the combination of adrenaline and tranexamic acid significantly reduced blood loss and enhanced surgical field quality compared to adrenaline alone. In Group II, adrenaline outperformed tranexamic acid in shortening surgery duration and improving surgical field quality. However, there was no significant difference in blood loss reduction between adrenaline and tranexamic acid. Conclusions: The study concluded that tranexamic acid is less effective than adrenaline when introduced as topical intranasal pledgets in both decreasing the time needed for the surgery and improving the subjective satisfaction of the surgeon while there is no significant difference regarding decreasing intraoperative blood loss. The mixture of adrenaline and tranexamic acid pledgets are more effective than adrenaline-only pledgets in terms of decreasing the intraoperative blood loss and improving the surgeon’s satisfaction with no significant difference regarding the time needed for the surgery.
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Ligon, Jona Minette E., and Natividad A. Almazan. "The Effectiveness of Intravenous Tranexamic Acid on Blood Loss and Surgical Time During Endoscopic Sinus Surgery: A Systematic Review." Philippine Journal of Otolaryngology-Head and Neck Surgery 31, no. 2 (2018): 8–12. http://dx.doi.org/10.32412/pjohns.v31i2.221.
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Objective: To review the effectiveness of intravenous tranexamic acid in reduction of blood loss, surgical time and field visualization among patients who underwent endoscopic sinus surgery (ESS) for chronic rhinosinusitis (CRS). 
 Methods:
 Data Sources: MEDLINE (PubMed), EMBASE, ScienceDirect, HERDIN, and the Cochrane Library.
 Eligibility Criteria: Randomized controlled trials (RCT) between 2005-2014 that evaluated the effects of tranexamic acid or placebo in patients undergoing ESS for CRS.
 Appraisal and Synthesis Methods: Articles were selected by 2 independent reviewers and methodological quality was blindly evaluated using a Jadad scale. Data were compiled in tables for analysis of outcome measures (estimated blood loss, length of surgery and intraoperative surgical field visualization).
 Results: Two trials were included in the study, enrolling 128 patients. One arm of the study had been given tranexamic acid while the other arm was given placebo (saline solution). Results varied for both studies. The summary of the observed difference for blood loss had a standardized mean difference of -51.20 (CI95 [-59.44, -42.95]) showing that the blood loss in milliliters was less in the tranexamic group compared to saline solution. The summary of the observed difference in surgical time had a standardized mean difference of -19.32 (CI95 [-24.21, -14.43]) showing that the surgical time in minutes was shorter in the tranexamic group compared to saline solution. The secondary outcome on surgical field visualization was not pooled together because the studies used different measurement scales.
 Limitations: The most important weaknesses of the 2 included studies were the differences in dose of tranexamic acid, scales of measurement of field visibility and age groups of the patients. 
 Conclusion: Tranexamic acid reduced blood loss and shortened surgical time after ESS among patients with CRS. However, the additional benefit of tranexamic acid for better field visualization was not clear. Adverse effects were not considered in this study, however results support the use of intravenous tranexamic acid intraoperatively as an option for ESS with blood loss as a concern. Further randomized clinical trials and an update on the systematic review will strengthen the evidence on the effectivity of tranexamic acid for ESS.
 Keywords: tranexamic acid, endoscopic sinus surgery, bleeding time
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Ashraf, Muhammad Asif, Ishfaq Ahmed, Sanaullah Bhatti, Deepak Rai, and Rana Farrukh Tasleem. "Compare Mean Blood Loss in Patients Undergoing Tonsillectomy with and without Tranexamic Acid." Pakistan Journal of Medical and Health Sciences 16, no. 7 (2022): 799–801. http://dx.doi.org/10.53350/pjmhs22167799.
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Introduction: Tonsillectomy is one of the most common surgeries in ENT department and bleeding is one of the most serious complications related to tonsillectomy. Tranexamic acid is a plasminogen inhibitor which has been successfully used to control bleeding in a variety of surgeries. Objective: The objective of this study is to compare mean blood loss in patients undergoing tonsillectomy with and without Tranexamic acid. Study Design: Randomized controlled trail Setting: This study was carried out at the Department of ENT Jinnah Hospital Lahore Sample Technique: Non-probability, consecutive sampling Study Duration: The study was done in 6 months after the approval of synopsis [March 8, 2017 till September 8, 2017] Materials and Methods: Sixty Patients were randomly divided into 2 equal groups using lottery method in group-A and group-B. Patients in Group-A received tranexamic acid after induction intravenously as 15 mg/kg (single bolus dose) over 10 min. Patients in group B were served as control group and they did not receive tranexamic acid before tonsillectomy. All surgeries were carried out by a single consultant having more than 5 years of experience after post-graduation. Blood loss was measured by researcher himself as per operational definition. Results: The mean age of cases in Tranexamic group was 19.70 ± 12.12 years while in control group was 21.53 ± 15.44 years. In Tranexamic acid group there were 18(60%) male and 12(40%) female cases while in control group there were 21(70%) male and 9(30%) female cases. The mean blood loss in Tranexamic acid group were 30.27 ±8.85 ml and in control group was 67.67 ± 14.91 ml. The mean blood loss was significantly less in Tranexamic acid group as compared to control group, p-value < 0.05. Conclusion: The mean blood loos in cases with Tranexamic acid were significantly lower as compared to control group. So in future every patient selected for tonsillectomy must be given TXA to reduce the blood transfusion and related complications of the patients. Keywords: ENT, Tonsillectomy, Bleeding, blood transfusion, Tranexamic acid
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Lecker, Irene, Dian-Shi Wang, Kirusanthy Kaneshwaran, C. David Mazer, and Beverley A. Orser. "High Concentrations of Tranexamic Acid Inhibit Ionotropic Glutamate Receptors." Anesthesiology 127, no. 1 (2017): 89–97. http://dx.doi.org/10.1097/aln.0000000000001665.
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Abstract Background The antifibrinolytic drug tranexamic acid is structurally similar to the amino acid glycine and may cause seizures and myoclonus by acting as a competitive antagonist of glycine receptors. Glycine is an obligatory co-agonist of the N-methyl-d-aspartate (NMDA) subtype of glutamate receptors. Thus, it is plausible that tranexamic acid inhibits NMDA receptors by acting as a competitive antagonist at the glycine binding site. The aim of this study was to determine whether tranexamic acid inhibits NMDA receptors, as well as α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid and kainate subtypes of ionotropic glutamate receptors. Methods Tranexamic acid modulation of NMDA, α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid, and kainate receptors was studied using whole cell voltage-clamp recordings of current from cultured mouse hippocampal neurons. Results Tranexamic acid rapidly and reversibly inhibited NMDA receptors (half maximal inhibitory concentration = 241 ± 45 mM, mean ± SD; 95% CI, 200 to 281; n = 5) and shifted the glycine concentration–response curve for NMDA-evoked current to the right. Tranexamic acid also inhibited α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid receptors (half maximal inhibitory concentration = 231 ± 91 mM; 95% CI, 148 to 314; n = 5 to 6) and kainate receptors (half maximal inhibitory concentration = 90 ± 24 mM; 95% CI, 68 to 112; n = 5). Conclusions Tranexamic acid inhibits NMDA receptors likely by reducing the binding of the co-agonist glycine and also inhibits α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid and kainate receptors. Receptor blockade occurs at high millimolar concentrations of tranexamic acid, similar to the concentrations that occur after topical application to peripheral tissues. Glutamate receptors in tissues including bone, heart, and nerves play various physiologic roles, and tranexamic acid inhibition of these receptors may contribute to adverse drug effects.
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Ghaly Tawadros, Safaa Ishak, Marwa A. Khairy, Eman A. Mohammed, and Mohamed M. Kamal. "Single intravenous bolus vs. continuous infusion of tranexamic acid to reduce blood loss in transurethral resection of prostate: a prospective randomized double-blind study." Anaesthesia, Pain & Intensive Care 29, no. 2 (2025): 210–16. https://doi.org/10.35975/apic.v29i2.2705.
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Background and objective: Intraoperative a single bolus of tranexamic acid may be inadequate to prevent bleeding in the early postoperative period. We compared the effect of two dose regimens of tranexamic acid in reducing perioperative blood loss and the amount of allogeneic blood transfusion in transurethral resection of prostate (TURP). Methods: A total of 50 patients electively posted for TURP, were randomly assigned to receive either a single bolus dose of tranexamic acid 10 mg/kg (Group A), or a bolus of tranexamic acid 10 mg/kg followed by an infusion of tranexamic acid @1 mg/kg/h till 4 h postoperatively (Group B). Perioperative blood loss and the amount of blood transfused were the primary outcome. Postoperative hemoglobin and hematocrit levels, incidence of deep vein thrombosis and any convulsions were the secondary outcomes. Results: There was no significant difference among patients in both groups regarding intraoperative and postoperative blood loss at 6 h and 48 h postoperatively. However, the postoperative blood loss at 24 h was significantly higher among patients in Group A (P = 0.014). Conclusion: Tranexamic acid used as intravenous bolus followed by infusion continued in the postoperative period is more effective in reduction of perioperative blood loss in comparison to single bolus in transurethral resection of prostate. Abbreviations: TURP: transurethral resection of prostate, TXA: tranexamic acid, Hct: hematocrit, DVT Key words: Antifibrinolytics, blood loss, transurethral resection of prostate, tranexamic acid. Citation: Ghaly Tawadros SI, Kamal MM, Mohammed EA, Khairy MA. Single intravenous bolus vs. continuous infusion of tranexamic acid to reduce blood loss in transurethral resection of prostate: a prospective randomized double-blind study. Anaesth. pain intensive care 2025;29(2):210-216. DOI: 0.35975/apic.v29i2.2705 Received: November 10, 2024; Reviewed: February 03, 2025; Accepted: February 05, 2025
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Law, Zhe Kang, Atte Meretoja, Stefan T. Engelter, et al. "Treatment of intracerebral haemorrhage with tranexamic acid – A review of current evidence and ongoing trials." European Stroke Journal 2, no. 1 (2016): 13–22. http://dx.doi.org/10.1177/2396987316676610.
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Purpose Haematoma expansion is a devastating complication of intracerebral haemorrhage (ICH) with no established treatment. Tranexamic acid had been an effective haemostatic agent in reducing post-operative and traumatic bleeding. We review current evidence examining the efficacy of tranexamic acid in improving clinical outcome after ICH. Method We searched MEDLINE, EMBASE, CENTRAL and clinical trial registers for studies using search strategies incorporating the terms ‘intracerebral haemorrhage’, ‘tranexamic acid’ and ‘antifibrinolytic’. Authors of ongoing clinical trials were contacted for further details. Findings We screened 268 publications and retrieved 17 articles after screening. Unpublished information from three ongoing clinical trials was obtained. We found five completed studies. Of these, two randomised controlled trials (RCTs) comparing intravenous tranexamic acid to placebo ( n = 54) reported no significant difference in death or dependency. Three observational studies ( n = 281) suggested less haematoma growth with rapid tranexamic acid infusion. There are six ongoing RCTs ( n = 3089) with different clinical exclusions, imaging selection criteria (spot sign and haematoma volume), time window for recruitment and dosing of tranexamic acid. Discussion Despite their heterogeneity, the ongoing trials will provide key evidence on the effects of tranexamic acid on ICH. There are uncertainties of whether patients with negative spot sign, large haematoma, intraventricular haemorrhage, or poor Glasgow Coma Scale should be recruited. The time window for optimal effect of haemostatic therapy in ICH is yet to be established. Conclusion Tranexamic acid is a promising haemostatic agent for ICH. We await the results of the trials before definite conclusions can be drawn.
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Xiaofei, Luo, Wie Xuan, and Wang Jinliang. "Effect of tranexamic acid on ischemia － reperfusion injury caused by application of tourniquet in the surgery of total knee arthroplasty." Orthopaedic Journal of Sports Medicine 8, no. 9_suppl7 (2020): 2325967120S0053. http://dx.doi.org/10.1177/2325967120s00532.
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Introduction: Tranexamic acid can effectively reduce the amount of perioperative bleeding in artificial joint replacement surgery, but some reports showing that the application of tranexamic acid in cardiac surgery can reduce the ischemia-reperfusion injury. Does tranexamic acid reduce the tourniquet Ischemia-reperfusion injury in the surgery of toutal knee arthroplasty is unclear. Hypotheses: To observe the effect of intravenous combined local tranexamic acid on the expression of IL-6 and TNF-α in peripheral blood and drainage fluid of patients with tourniquet in primary total knee arthroplasty Methods: Sixty patients with knee osteoarthritis were selected from 2017-07 to 2018-06 to proceed primary knee arthroplasty in our hospital. The random digital table was used to divide them into tranexamic acid group and normal saline group, with 30 cases in each group. In the tranexamic acid group, tranexamic acid 1g in 100ml normal saline was infused intraoperatively and at 3 h after operation. After incision, the infusion of tranexamic acid 1g in 100ml normal saline was performed. The saline group only 100 ml of physiological saline was infused during the same period of time, and 100 ml of physiological saline was locally perfused. The operation time, intraoperative blood loss, and drainage volume at 24 hours after operation were compared. The levels of IL-6 and TNF-α in the drainage fluid before and after surgery were compared between the two groups. Results: The drainage volume of tranexamic acid group was lower than that of normal saline group (P < 0.05). The levels of IL-6 and TNF-α in serum were lower than those in normal saline group at 24h and 72h after operation. The difference was statistically significant. (P < 0.05); the expression of IL-6 and TNF-α in the drainage fluid was significantly lower than that in the saline group at 24 hours after surgery (P < 0.05) Conclusion: Combined use of tranexamic acid can effectively reduce the expression of IL-6 and TNF-α in local drainage fluid and peripheral serum after TKA in patients with TKA, thus reducing the local and systemic inflammatory response.
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Clinkard, David, and David Barbic. "Tranexamic Acid for Epistaxis–A Promising Treatment That Deserves Further Study." CJEM 18, no. 1 (2015): 72–73. http://dx.doi.org/10.1017/cem.2015.55.
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Clinical QuestionDoes the application of topical tranexamic acid reduce bleeding as compared to anterior packing?Article ChosenZahed 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.ObjectivesTo determine if topically applied tranexamic acid reduces bleeding time in epistaxis.
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Liu, Jingyi, Ximing Nie, Hongqiu Gu, et al. "Tranexamic acid for acute intracerebral haemorrhage growth based on imaging assessment (TRAIGE): a multicentre, randomised, placebo-controlled trial." Stroke and Vascular Neurology 6, no. 2 (2021): 160–69. http://dx.doi.org/10.1136/svn-2021-000942.
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BackgroundStudies show tranexamic acid can reduce the risk of death and early neurological deterioration after intracranial haemorrhage. We aimed to assess whether tranexamic acid reduces haematoma expansion and improves outcome in intracerebral haemorrhage patients susceptible to haemorrhage expansion.MethodsWe did a prospective, double-blind, randomised, placebo-controlled trial at 10 stroke centres in China. Acute supratentorial intracerebral haemorrhage patients were eligible if they had indication of haemorrhage expansion on admission imaging (eg, spot sign, black hole sign or blend sign), and were treatable within 8 hours of symptom onset. Patients were randomly assigned (1:1) to receive either tranexamic acid or a matching placebo. The primary outcome was intracerebral haematoma growth (>33% relative or >6 mL absolute) at 24 hours. Clinical outcomes were assessed at 90 days.ResultsOf the 171 included patients, 124 (72.5%) were male, and the mean age was 55.9±11.6 years. 89 patients received tranexamic acid and 82 received placebo. The primary outcome did not differ significantly between the groups: 36 (40.4%) patients in the tranexamic acid group and 34 (41.5%) patients in the placebo group had intracranial haemorrhage growth (OR 0.96, 95% CI 0.52 to 1.77, p=0.89). The proportion of death was lower in the tranexamic acid treatment group than placebo group (8.1% vs 10.0%), but there were no significant differences in secondary outcomes including absolute intracranial haemorrhage growth, death and dependency.ConclusionsAmong patients susceptible to haemorrhage expansion treated within 8 hours of stroke onset, tranexamic acid did not significantly prevent intracerebral haemorrhage growth. Larger studies are needed to assess safety and efficacy of tranexamic acid in intracerebral haemorrhage patients.
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Bao, Xianguo, Haitao Lu, Zengxin Gao, et al. "Meta-Analysis of the Efficacy and Safety of Tranexamic Acid in Spinal Surgery." Computational and Mathematical Methods in Medicine 2022 (July 27, 2022): 1–10. http://dx.doi.org/10.1155/2022/9406497.
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Objective. The safety and effectiveness of topical tranexamic acid in spinal surgery has not yet been reached, and further research is needed to confirm it. This study is aimed at detecting the effectiveness and safety on the tranexamic acid in spinal surgery. Methods. The Cochrane Library, PubMed, Embase, CNKI, and other databases were searched. The search time was from 2016 to 2019. All randomized controlled trials comparing the topical tranexamic acid group and the control group were collected. The experimental group used topical application. Tranexamic acid was used to treat bleeding after spinal surgery. The control group was no tranexamic acid or isotonic saline. The total bleeding, blood transfusion rate, and the occurrence of deep vein thrombosis were compared between the two groups. Rev Man 5.2.0 software was used for meta-analysis. Results. A total of 8 randomized controlled trials were included, including 884 patients. Meta-analysis results showed that the total bleeding volume of the tranexamic acid group was lower than that of the control group, and the difference was statistically significant weighted mean difference ( WMD = – 360.27 mL , 95% confidence interval (CI) (–412.68, –307.87) mL, P < 0.00001 ). The blood transfusion rate in the tranexamic acid group was lower than that in the control group (odds ratio OR = 0.22 , 95% CI (0.14, 0.33), P < 0.00001 ). There was no significant difference in the incidence of deep vein thrombosis between the two groups: OR = 1.48 , 95% CI (0.41, 5.34), P = 0.55 . Conclusion. Tranexamic acid can significantly reduce perioperative total blood loss, intraoperative blood loss, and blood transfusion rate during spinal surgery but has no significant effect on blood transfusion and thrombosis.
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Azkiyah, Siti Zamilatul, Sudibyo Supardi, and Retnosari Andrajati. "THE RISKS OF USING TRANEXAMIC ACID AND VITAMIN K FOR DECREASING PROTHROMBIN TIME AND ACTIVATED PARTIAL THROMBOPLASTIN TIME VALUES IN INTRACRANIAL HEMORRHAGIC PATIENTS AT RUMAH SAKIT UMUM PUSAT FATMAWATI JAKARTA." Asian Journal of Pharmaceutical and Clinical Research 10, no. 17 (2017): 139. http://dx.doi.org/10.22159/ajpcr.2017.v10s5.23117.
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Objective: Intracranial hemorrhaging is a life-threatening condition that requires intensive treatment. Such hemorrhaging can happen spontaneously and may be caused by vascular malformations, trauma, or the administration of anticoagulant medications. The purpose of this study was to evaluate the risks of using tranexamic acid and Vitamin K for decreasing prothrombin time (PT) and activated partial thromboplastin time (aPTT) values in intracranial hemorrhagic patients.Methods: This study used a retrospective cohort design, and data were taken from patients’ medical records at the medical record installation of Rumah Sakit Umum Pusat Fatmawati in Jakarta. A total of 125 medical records were selected based on the inclusion criteria. The first group included patients receiving only tranexamic acid, and the second group consisted of patients receiving both tranexamic acid and Vitamin K.Results: Statistical analysis using Chi-squared testing for the first group showed a significant decrease in aPTT values, with p=0.000 (p<0.05), but there was no significant decrease in PT values, with p=0.314 (p<0.05). Statistical analysis using Chi-squared testing in the second group showed a significant decrease in aPTT values, with p=0.000 (p<0.05), and a significant decrease in PT values, with p=0.034 (p<0.05). Patients that used tranexamic acid and Vitamin K decreased the PT and aPTT values 2.7 times and 1, 6 times greater than patients without tranexamic acid and Vitamin K. Patients that used tranexamic acid decreased the PT and aPTT values 2.5 times and 1.2 times greater than patients without tranexamic acid.Conclusions: The combination of tranexamic acid and Vitamin K is potentially more effective in decreasing of hemorrhaging.
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Akinlua, Gbenga Damilola, Jacob Olumuyiwa Awoleke, Idowu Pius Ade-Ojo, Samson Gbenga Oluwayomi, Omoyemi Adeoti Akinlua, and Margaret Adefiola Oluwayemi. "Effect of Intravenous Tranxenamic Acid On Incidence of Postpartum Haemorrhage Among Parturients in Ekiti State." nternational Journal of Public Health Pharmacy and Pharmacology 8, no. 4 (2023): 26–34. http://dx.doi.org/10.37745/ijphpp.15/vol8n42634.
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Post-partum haemorrhage (PPH) contributes to approximately 25% of maternal death globally. Tranexamic acid (TXA) has been confirmed to be effective in reducing post-partum blood loss, thereby preventing PPH and its possible sequelae. This clinical controlled trial compared the efficacy of a single dose of 0.5g of intravenous TXA to a single dose of 1g of intravenous TXA in prevention of primary PPH among high-risk parturient women in a teaching hospital. A total of 308 women served as the study sample; 154 women were randomly selected to be administered with 0.5g of tranexamic acid (study group), while the remaining 154 respondents were administered with 1g of tranexamic acid (control group). Post-partum blood loss was monitored immediately. All results were recorded in a proforma. Data were coded and entered into Statistical Package for the Social Sciences (SPSS) version 23. Continuous variables were presented as mean ± Standard deviation while categorical data such as frequency tables and percentages. Student’s t-test was used as appropriate for statistical significance. Results were considered statistically significant when P< 0.05. The mean blood loss of 475.79ml was higher in the study group compared to the mean blood loss of 430.18ml in the control group, this was statistically significant, (t=2.401, p<0.05). In conclusion, the 1g of tranexamic acid is more effective in the prevention of PPH compared to the 0.5g of tranexamic acid. It was recommended that 0.5g of tranexamic can be administered in the face of challenges at obtaining the standard 1g doses of tranexamic acid. However, the 1g standard dose of tranexamic acid is still the recommended dose especially for high-risk patients
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Sethna, Navil F., David Zurakowski, Robert M. Brustowicz, Julianne Bacsik, Lorna J. Sullivan, and Frederic Shapiro. "Tranexamic Acid Reduces Intraoperative Blood Loss in Pediatric Patients Undergoing Scoliosis Surgery." Anesthesiology 102, no. 4 (2005): 727–32. http://dx.doi.org/10.1097/00000542-200504000-00006.
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Background Excessive bleeding often occurs during pediatric scoliosis surgery and is attributed to numerous factors, including accelerated fibrinolysis. The authors hypothesized that administration of tranexamic acid would reduce bleeding and transfusion requirements during scoliosis surgery. Methods Forty-four patients scheduled to undergo elective spinal fusion were randomly assigned to receive either 100 mg/kg tranexamic acid before incision followed by an infusion of 10 mg . kg . h during surgery (tranexamic acid group) or 0.9% saline (placebo group). General anesthesia was administered according to a standard protocol. Blood loss, transfusion requirements, coagulation parameters, and complications were assessed. Results In the tranexamic acid group, blood loss was reduced by 41% compared with placebo (1,230 +/- 535 vs. 2,085 +/- 1,188 ml; P &lt; 0.01). The amount of blood transfused did not differ between groups (615 +/- 460 vs. 940 +/- 718 ml; P = 0.08). Administration of tranexamic acid was a multivariate predictor of blood loss, as was American Society of Anesthesiologists physical status and preoperative platelet count. No apparent adverse drug effects occurred in any patient. Conclusion Intraoperative administration of tranexamic acid significantly reduces blood loss during spinal surgery in children with scoliosis.
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Prathap, Mr A., Roja M K, Samyuktha D V, Saranya R, Shruthi D, and Priyadarshini P. "Tranexamic Acid and its Role in Total Knee Replacement." International Journal for Research in Applied Science and Engineering Technology 11, no. 9 (2023): 518–25. http://dx.doi.org/10.22214/ijraset.2023.55659.
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Abstract: Tranexamic acid is a synthetic lysine derivative that inhibits the lysine binding sites on plasminogen molecules in order to have an antifibrinolytic action. In patients with upper gastrointestinal bleeding, tranexamic acid was related to mortality decreases of 5 to 54% when compared to placebo. A 40% reduction was found by meta-analysis. Tranexamic acid therapy reduced mean menstrual blood loss in menstruating women with menorrhagia by 34 to 57.9% in comparison to placebo or control; the medication has also been successfully used to treat placental bleeding, postpartum hemorrhage, and cervix conization. In hemophiliac patients undergoing oral surgery, tranexamic acid considerably decreased mean blood losses, and it worked well as a mouthwash for dental patients taking oral anticoagulants. With the administration of the medication, blood loss was also decreased in patients having orthotopic liver transplantation or transurethral prostate surgery, and rebleeding rates were decreased in patients with traumatic hyphaema. Patients with hereditary angioneurotic edema have also claimed clinical improvement from tranexamic acid. The most frequent adverse reactions to tranexamic acid are nausea and diarrhea. Clinical trials have not shown that the medication increases the risk of thrombosis
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Dogbanya, Gabriel. "Effect of Tranexamic Acid on Primary Postpartum Haemorrhage in at Risk Women at Abuth, Zaria: A Randomized Controlled Study." Journal of Medical Science And clinical Research 11, no. 08 (2023): 01–09. http://dx.doi.org/10.18535/jmscr/v11i8.01.
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Background: Postpartum haemorrhage is an obstetric nightmare. Although it may occur in women with no identified risk, women with certain risk profiles are at increased risk PPH. Tranexamic acid has been shown to be effective in low risk women. Aim: To compare the effectiveness of Tranexamic acid to placebo in preventing PPH in at-risk women following vaginal delivery. Research Methods: The study was a randomized controlled trial at ABUTH, Zaria, in which 334 women identified as being at risk for PPH, were sequentially randomized into Tranexamic and placebo groups of 167 each. The Tranexamic acid group received intravenous 1g Tranexamic acid made up to 20ml with 0.9% Normal saline, while the placebo group received 20ml 0.9% Normal saline at delivery. Both groups received I.M 10IU oxytocin as part of AMTSL protocol. Blood loss was collected objectively in a blood collection drape at delivery.
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Barbilian, Raluca Costina, Victor Cauni, Bogdan Mihai, Ioana Buraga, Mihai Dragutescu, and Dan Mischianu. "The Control of Bloodloss During Percutanerous Nephrolithotomy Using Tranexamic Acid." Revista de Chimie 69, no. 10 (2018): 2728–30. http://dx.doi.org/10.37358/rc.18.10.6612.
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The aim of this study is to assess the efficiency and safety of the tranexamic acid in reducing hemmorrhagic complications and transfusion requirements in patients with renal lithiasis treated by percutaneous approach. Percutaneous nephrolithotomy (PCNL) is a minimally invasive technique used for large kidney stones (]20mm). Urinary sepsis and intra or postoperative bleeding are the very serious complications associated with this type of procedure. Tranexamic acid is used in the treatment of many haemorrhagic conditions. The experience with tranexamic acid in preventing bloodloss during percutaneous nephrolithotomy is very limited. The use tranexamic acid in percutaneous nephrolithotomy is safe and is associated with reduced blood loss and a lower transfusion rate.
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Tencza, Elizabeth, Andrew J. Harrell, and Preeyaporn Sarangarm. "Effect of tranexamic acid administration time on blood product use in urban trauma patients." American Journal of Health-System Pharmacy 77, Supplement_2 (2020): S46—S53. http://dx.doi.org/10.1093/ajhp/zxaa074.
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Abstract Purpose To evaluate the effect of time to tranexamic acid administration on blood product usage in trauma patients and to assess the potential benefit of initiating a protocol for field administration by ground ambulance personnel. Methods Adult patients with traumatic injuries who received 1 g of tranexamic acid during the period January 2014 through June 2016 were retrospectively identified via review of automated dispensing cabinet and electronic medical record data and cross-referencing with the New Mexico Trauma Registry. Exclusion criteria included tranexamic acid use for nontrauma indications, previous admission for trauma during the study period, and a lack of pertinent information regarding the time, type, or severity of trauma in available records. The primary outcome was blood product use (aggregate of units of platelets, packed red blood cells [pRBCs], and fresh frozen plasma [FFP]) in the first 24 hours of hospital admission. Results The analysis included 107 patient cases, with a median transport time of 20 minutes (range, 7-103 minutes); 73% of reported transport times were less than 30 minutes. All patients received a loading dose of tranexamic acid in the hospital, with the exception of 2 patients who received tranexamic acid in the field. Administration of a tranexamic acid loading dose was documented within 3 hours for 90.7% of patients, with a mean time to administration of 91.9 minutes. A mean (SD) total of 14.8 (16.0) units of blood products (range, 0-91 units) were administered, consisting of a mean (SD) of 8.0 (8.4) units of pRBCs (range, 0-48 units), 5.6 (7.5) units of FFP (range, 0-38 units), and 1.2 (1.7) units of platelets (range, 0-7 units). Time to tranexamic acid administration did not affect blood product usage in the first 24 hours of admission after adjusting for potential confounders. Conclusion Earlier administration of tranexamic acid was not associated with a decrease in use of blood products. This finding, paired with the relatively short ground transport times typical for our institution, makes it unlikely that field administration of tranexamic acid would benefit the evaluated patient population.
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Timmy Wibisono, Budi Sutikno, Titiek Hidayati Ahadiah, Budi Utomo, and Citrawati Dyah Kenconowungu. "Comparison of the efficacy of hot saline irrigation and tranexamic acid on Boezaart score, intraoperative blood loss, and duration of surgery in functional endoscopic sinus surgery: a systematic review and meta-analysis." Bali Medical Journal 12, no. 2 (2023): 1414–20. http://dx.doi.org/10.15562/bmj.v12i2.4362.
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Link of Video Abstract: https://youtu.be/wEp6PioGVqw Background: Hot saline irrigation and tranexamic acid are techniques used to control bleeding during functional endoscopic sinus surgery (FESS). Hot saline irrigation and tranexamic acid can help control bleeding originating from microvascular located in the nasal cavity and paranasal sinuses. This study aims to compare the efficacy of these two techniques on Boezaart score, intraoperative blood loss, and duration of surgery in functional endoscopic sinus surgery. Methods: This study is an intervention meta-analysis, the research formulated based on the population, intervention, comparison, outcome, and study design (PICOS). Articles were searched from five databases, including PubMed Central and publisher websites, Cochrane Library, ResearchGate, SAGE Journals, and Web of Science. There were no publication year or publication status restrictions on the selected research articles, and the date of the last search was up to February 2023. The efficacy of hot saline irrigation as a bleeding control method compared to tranexamic acid was assessed based on Boezaart surgical field score, intraoperative bleeding, and duration of surgery in functional endoscopic sinus surgery (FESS). Results: A total of 532 research articles were identified, and fifteen articles that met the inclusion and exclusion criteria were selected. Hot saline irrigation p-value p=0.0002 and for tranexamic acid p=<0.00001 based on Boezaart score. Hot saline irrigation p= 0.0001 and tranexamic acid had a p= 0.0002 based on the Intraoperative blood loss, but the standardized mean difference in the hot saline irrigation group was smaller compared to the tranexamic acid topical group. Hot saline irrigation p=0.06 and tranexamic acid p=0.13 for duration of surgery. Conclusion: This meta-analysis showed that the administration of tranexamic acid or hot saline irrigation could significantly reduce duration of surgery, intraoperative blood loss and improved surgical feld quality compared with room temperature saline irrigation. There is no statistically significant difference between tranexamic acid topical and hot saline irrigation.
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Jawad, Ariana. "Tranexamic acid for antenatal bleeding of unknown origin in the second and third trimesters: A prospective clinical trial." Zanco Journal of Medical Sciences 25, no. 2 (2021): 532–43. http://dx.doi.org/10.15218/zjms.2021.017.
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Background and objective: Vaginal bleeding is a common complication in pregnancy and is associated with poor perinatal outcomes. This study aimed to determine the efficacy of tranexamic acid in stopping vaginal bleeding during pregnancy and improving perinatal outcomes. Methods: A prospective clinical trial was conducted on 137 pregnant women with vaginal bleeding of unknown causes in the second and third trimesters of pregnancy who were admitted to Maternity Teaching Hospital, Erbil city, Kurdistan region, Iraq from February 2016 to November 2019. Tranexamic acid was administered to one group and normal supportive care to another group in a sequential manner. The Mann–Whitney test was used to compare the mean rank of the times of admission. Factors that were significantly associated with stoppage of bleeding were entered into a binary logistic regression model. Results: Bleeding was stopped in 90% of women who received tranexamic acid. There was a significant difference in low Apgar score, the rate of low birth weight, and the rate of unfavorable perinatal outcome in the supportive care group than that in the tranexamic acid group. Predictors for not stopping bleeding were supportive care management compared with tranexamic acid (odds ratio (OR) = 13.38; 95% confidence interval (CI) = 3.60–49.67), and 21–32 weeks gestation compared with ≥ 37 weeks (OR = 6.52; 95% CI = 1.66–25.63). Conclusion: Tranexamic acid in second and third trimesters bleeding is effective for rapidly arresting bleeding with a favorable neonatal outcome. Keywords: Antifibrinolytic agent; Miscarriage; Neonatal death; Preterm labor; Tranexamic acid.
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Ergun, Bulent, Ercan Bastu, Mehmet Ozsurmeli, and Cem Celik. "Tranexamic Acid: A Potential Adjunct to Resectoscopic Endometrial Ablation." International Surgery 97, no. 4 (2013): 310–14. http://dx.doi.org/10.9738/cc149.1.
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Abstract Abnormal uterine bleeding (AUB) is a substantial cause of ill health in women worldwide. In this study, our aim was to evaluate the effectiveness of endometrial ablation using a modified urologic resectoscope along with tranexamic acid in AUB. Sixty patients were enrolled in this study. All patients underwent resectoscopic surgery. Patients were randomly divided into two groups. Group 1 (n = 30) received 500 mg of tranexamic acid. Group 2 (n = 30) served as the control group and underwent surgery without the administration of tranexamic acid. Total pictorial blood loss assessment chart (PBAC) scores were significantly lower postoperatively (152.14 ± 9.65 versus 6.6 ± 0.90; P &lt; 0.001). When stratified by the administration of tranexamic acid, the number of patients with a postoperative day 1 PBAC score ≤15 was higher in the tranexamic group (19 versus 13), whereas the number of patients with a post operative day 1 PBAC score &gt;15 was lower in the tranexamic group (11 versus 17), but the differences were not statistically significant (P &gt; 0.05). AUB is a complex disease that may need repeated treatments. In expert hands, the treatment rate of resectoscopic surgery seems acceptable. However, some patients may require additional interventions, like repeated surgery, hysterectomy, or a drug therapy in the long run. Introduction of tranexamic acid as a potential adjunct to rollerball endometrial ablation may present an interesting option that requires additional well-designed studies before firm conclusions can be made.