Effectiveness of tranexamic acid for reducing intraoperative bleeding in palatoplasties: A randomized clinical trial

Arantes, Guilherme Campelo; Pereira, Rui; Melo, Daniela Bezerra de; Alonso, Nivaldo; Duarte, Mariano

doi:10.1016/j.jcms.2016.12.021

Cited by 22 publications

(18 citation statements)

References 74 publications

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“…[4][5][6] When reviewing the literature, we found that TXA has been studied and used in a wide range of settings, especially in the surgical fields including orthopedic procedures, otolaryngologic surgery, obstetric bleeding and heavy menstrual bleeding, pediatric cardiac surgery, and coronary artery surgery. 2,[8][9][10][11] A large meta-analysis evaluating TXA in surgical patients showed that TXA reduced the need for blood transfusion and resulted in fewer deaths. 11 It has also been studied for the treatment of epistaxis.…”

Section: Discussionmentioning

confidence: 99%

Tranexamic Acid in a Case Report of Life-threatening Nontraumatic Hemorrhage in Immune Thrombocytopenic Purpura

Randall

Nurse

Singh

2020

Clinical Practice and Cases in Emergency Medicine

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Introduction: Immune thrombocytopenic purpura (ITP) is an autoimmune-mediated disorder in which the body produces antibodies that destroy platelets, causing an increased risk of bleeding and bruising. Tranexamic acid (TXA) is a medication that prevents clot breakdown and is used to treat uncontrolled bleeding. Case Report: We present the case of an 11-year-old female with significant epistaxis and hypotension in the emergency department. Traditional therapies were initiated; however, the patient continued to have bleeding and remained hypotensive, so intravenous TXA was given. The patient’s bleeding then resolved. Conclusion: TXA may be a safe and effective adjunct to traditional therapies for the treatment of life-threatening hemorrhage in ITP patients.

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Section: Discussionmentioning

confidence: 99%

Tranexamic Acid in a Case Report of Life-threatening Nontraumatic Hemorrhage in Immune Thrombocytopenic Purpura

Randall

Nurse

Singh

2020

Clinical Practice and Cases in Emergency Medicine

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“…Of the reviewed studies, fifteen assessed the use of TXA in craniofacial surgery procedures [29][30][31][32][33][34][35][36][37][38][39][40][41][42][43]. Of these, nine were retrospective cohort studies [29-31, 34, 35, 38-40, 42], and six were randomized controlled clinical trials [32,33,36,37,41,43]. Study sample ranged from 25 to 187 patients, apart from a single retrospective cohort study of 1638 patients.…”

Section: Craniofacial Surgerymentioning

confidence: 99%

“…Study sample ranged from 25 to 187 patients, apart from a single retrospective cohort study of 1638 patients. Thirteen studies assessed the use of TXA in craniosynostosis surgery, while just two studies investigated using TXA in palatoplasties [36,43]. In all included studies, a significant portion of the study population was pediatric.…”

Section: Craniofacial Surgerymentioning

confidence: 99%

“…In addition, Kurnik NM et al reported using a 4h infusion of TXA for reducing blood loss in craniosynostosis surgery to be associated with a lower overall cost, although equally effective, compared to a 24-h infusion [39]. However, both Arantes et al and Maugans et al reported that TXA use was not associated with a significant difference in intraoperative bleeding and transfusion volume, respectively [38,43]. In addition, Fenger-Eriksen C et al reported that use of TXA was not associated with a significant difference in 92 screened inflammatory parameters compared to a placebo group.…”

Section: Craniofacial Surgerymentioning

confidence: 99%

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Tranexamic acid in plastic surgery: routes of administration and dosage considerations

et al. 2021

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Background Excessive blood loss, during or after surgery, remains a major surgical concern despite the continuous improvement of surgical standards. Tranexamic acid (TXA), an anti-fibrinolytic, is a potential agent that has been used in a variety of methods to mitigate blood loss. In addition, TXA shows additional anti-inflammatory effects which may be of particular interest. The objective of this study is to review clinical studies involving the use of TXA in plastic surgery related procedures. Methods We carried out a literature search of Google Scholar, PubMed, Ovid Medline, and Cochrane databases since their inception for relevant clinical studies on TXA use (dosages/routes of administration) in plastic surgery-related procedures. Results Forty-five articles were included in this review. These included studies assessing the use of TXA in craniofacial surgery (15 studies), aesthetic and breast-related surgeries (23 studies), burn care (4 studies), and microsurgery (3 studies). For each subset, study design, study sample size, surgical procedure performed, TXA route of administration, dosage, study outcomes, and adverse events were summarized and reported in a separate section. Conclusions TXA is widely studied in the field of craniofacial surgery, specifically craniosynostosis surgery. Intravenous administration of TXA is the most commonly studied route of administration. Topical formulations seem to be on the rise and the added local anti-inflammatory effects and safety profile of topical use add significant appeal. Moreover, evidence on appropriate dosage protocols is scarce. The variable approach in dosing warrants further trials to assess the clinical implications, as well as potential benefit in using TXA more efficiently in the field of plastic surgery, as a whole. Level of evidence: Not ratable

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“…Please refer to Table 1 for several references of pro-coagulant TXA in plastic, reconstructive, and craniomaxillofacial surgery [19,20,21], as well as to Table 2, outlining studies analyzing the use of topical thrombin [22,23].…”

Section: Introductionmentioning

confidence: 99%

Local Pro- and Anti-Coagulation Therapy in the Plastic Surgical Patient: A Literature Review of the Evidence and Clinical Applications

et al. 2019

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The risks of systemic anti-coagulation or its reversal are well known but accepted as necessary under certain circumstances. However, particularly in the plastic surgical patient, systemic alteration to hemostasis is often unnecessary when local therapy could provide the needed adjustments. The aim of this review was to provide a summarized overview of the clinical applications of topical anti- and pro-coagulant therapy in plastic and reconstructive surgery. While not a robust field as of yet, local tranexamic acid (TXA) has shown promise in achieving hemostasis under various circumstances, hemostats are widely used to halt bleeding, and local anticoagulants such as heparin can improve flap survival. The main challenge to the advancement of local therapy is drug delivery. However, with increasingly promising innovations underway, the field will hopefully expand to the betterment of patient care.

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Effectiveness of tranexamic acid for reducing intraoperative bleeding in palatoplasties: A randomized clinical trial

Cited by 22 publications

References 74 publications

Tranexamic Acid in a Case Report of Life-threatening Nontraumatic Hemorrhage in Immune Thrombocytopenic Purpura

Tranexamic Acid in a Case Report of Life-threatening Nontraumatic Hemorrhage in Immune Thrombocytopenic Purpura

Tranexamic acid in plastic surgery: routes of administration and dosage considerations

Local Pro- and Anti-Coagulation Therapy in the Plastic Surgical Patient: A Literature Review of the Evidence and Clinical Applications

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