Repeat-dose intravenous tranexamic acid further decreases blood loss in total knee arthroplasty

Iwai, Tomohiro; Tsuji, Shigeyoshi; Tomita, Tadanori; Sugamoto, Kazuomi; Yoshikawa, Hideki; Hamada, Masayuki

doi:10.1007/s00264-013-1787-7

Cited by 80 publications

(75 citation statements)

References 22 publications

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“…Our results are consistent with their study. In patients undergoing Total Knee Arthroplasty, Iwai T et al (21) found that with single dose of Tranexamic Acid the blood loss was 1246.6 ml whereas with a two dose regimen it was 915.3 ml when compared with Control group (1538.3 ml). Hiippala ST et al (9) …”

Section: Blood Lossmentioning

confidence: 99%

Evaluate The Role of Tranexamic Acid In Joint Replacement Surgeries

Yadav¹,

Chauhan²,

Peshin³

2017

IOSR JDMS

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Section: Blood Lossmentioning

confidence: 99%

Evaluate The Role of Tranexamic Acid In Joint Replacement Surgeries

Yadav¹,

Chauhan²,

Peshin³

2017

IOSR JDMS

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“…Some authors recommended pre-operative blood donation [14], correction of preoperative anaemia [15], autologous donation and retransfusion systems [10,[16][17][18][19][20][21][22][23], supplementation of erythropoietin or iron [24,25], pharmacologic agents like tranexamic acid [26,27], plasmapheresis, normovolaemic haemodilution [28][29][30][31] and post-operative red blood cell salvage [32].…”

Section: Introductionmentioning

confidence: 99%

Effectiveness of an autologous transfusion system following cemented and non-cemented revisions of total hip arthroplasty

Hawi

Kendoff

Hessling

et al. 2014

International Orthopaedics (SICOT)

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Purpose The goal of this study was to analyse the efficacy of blood autotransfusion using a continuous autologous transfusion system in revisions of total hip arthroplasty (THA). We looked at whether administration of allogeneic blood units was reduced in these cases and if there is a difference between cemented and non-cemented revisions. Methods Between January 2011 and December 2011, patients being treated with revision THA were included (n=411). The following parameters were analysed: patient age, gender, weight (kg), height (cm), body mass index (BMI, kg/m 2 ), surgical diagnosis, treatment and American Society of Anesthesiologists (ASA) classification score. The difference between pre-and post-operative haemoglobin (Hb, g/dl), amount of peri-operative blood loss (ml), amount of retransfused washed shed blood and amount of allogeneic and/or autologous transfusion (ml) were recorded. Results In both the cemented and non-cemented revision THA groups, there was no significant difference between pre-and post-operative Hb with or without using an autotransfusion system. In 92 of 186 cemented cases using an autologous transfusion system (49.5 %) and 38 of 117 non-cemented cases using an autologous transfusion system (32.5 %), allogeneic blood transfusion (ABT) was required. Cemented procedures using an autologous transfusion system got significantly more ABTs than non-cemented procedures using an autologous transfusion system (p=0.0042, odds ratio=2.035).Conclusions Use of an autologous transfusion system did not reduce the amount of ABT in revision THA in the patient cohort reported here. In our opinion, general blood management is required before and during surgery to reduce administration of ABT.

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“…With PABD there was no reduction in allogeneic blood transfusions and a large number of taken doses of autologous blood was discarded, which significantly increased the cost of treatment for these patients. We believe that in non-anaemic patients other factors can influence significant reduction of blood loss: good surgical techniques, regional anaesthesia, post-operative autotransfusion, oral iron therapy and maybe tranexamic acid [24] or platelet-rich plasma [25]. For patients undergoing TKA, PABD can provoke iatrogenic anaemia and thereby increase the likelihood of the need for allogeneic blood transfusion.…”

Section: Resultsmentioning

confidence: 99%

Pre-operative autologous blood donation versus no blood donation in total knee arthroplasty: a prospective randomised trial

Blazekovic

Bićanić

Hrabač

et al. 2013

International Orthopaedics (SICOT)

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Purpose During total knee arthroplasty (TKA) blood loss can be significant and in spite of all techniques for reducing blood loss there is still a significant possibility for blood transfusions. For blood loss management during TKA, pre-operative autologous blood donation (PABD) is still a standard of care. In this prospective randomised study we have evaluated the efficacy of PABD in patients undergoing TKA to answer the question whether there is any need for autologous blood donations during TKA and, if yes, for which group of patients. Methods Patients were randomised to three groups. In group 1 patients did not donate autologous blood, in group 2 patients donated 1 dose 72 hours prior to TKA and in group 3 patients donated autologous blood 14 days prior to TKA. In all patients haemoglobin, haematocrit, thrombocyte and reticulocyte values, iron concentrations (Fe, unsaturated iron binding capacity, total iron binding capacity), activated partial thromboplastin time, prothrombin time, and intra-operative and postoperative blood loss were measured and compared. Results With PABD there was no reduction in allogeneic blood transfusions and a large number of taken doses of autologous blood was discarded, which significantly increased the cost of treatment for these patients. For patients undergoing TKA, PABD can provoke iatrogenic anaemia and thereby increase the likelihood of the need for allogeneic blood transfusion. Conclusions Results of our study showed that PABD in nonanaemic patients is not justified and is not economically feasible.

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Repeat-dose intravenous tranexamic acid further decreases blood loss in total knee arthroplasty

Abstract: Administration of TXA twice reduced postoperative blood loss after TKA, and TXA was not associated with the risk of deep-vein thrombosis (DVT) or pulmonary embolism (PE). Further, administration of TXA twice may eliminate the need for blood transfusion during TKA.

Cited by 80 publications

References 22 publications

Evaluate The Role of Tranexamic Acid In Joint Replacement Surgeries

Evaluate The Role of Tranexamic Acid In Joint Replacement Surgeries

Effectiveness of an autologous transfusion system following cemented and non-cemented revisions of total hip arthroplasty

Pre-operative autologous blood donation versus no blood donation in total knee arthroplasty: a prospective randomised trial

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