The effect of tranexamic acid on the values of activated clotting time in patients undergoing cardiac surgery: A PRISMA-compliant systematic review and meta-analysis

Yao, Yun-Tai; He, Li-Xian; Tan, Jie-chao

doi:10.1016/j.jclinane.2020.110020

Cited by 8 publications

(9 citation statements)

References 27 publications

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“…TXA is synthetic lysine analog that inhibits the activation of plasminogen to plasmin [ 12 ]. It is routinely used in orthopedic and cardiac surgery to reduce the perioperative bleeding [ 9 , 10 ]. Although the efficacy of TXA has been confirmed in studies, current studies have focused on effective dose adjustment as well as careful evaluation of use in elderly patients [ 10 , 17 ].…”

Section: Discussionmentioning

confidence: 99%

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Effectiveness of prophylactic doses of tranexamic acid in reducing hemorrhagic events in sleeve gastrectomy

Lech

Michalik

Waczyński

et al. 2022

Langenbecks Arch Surg

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Purpose Laparoscopic sleeve gastrectomy (LSG) is currently the most common bariatric surgery in the world. Although it appears to be a safe treatment for obesity, it is still at risk of complications. The latest literature shows that postoperative bleeding occurs in 2–4% of cases, and up to 3% of cases requires reoperation for hemostasis. The aim of the study is to assess the effect of tranexamic acid (TXA) on hemorrhagic events and the reoperation rate in patients undergoing LSG. Methods The study was designed as a retrospective analysis of patients undergoing LSG. We investigate the patients 6 months before and 6 months after introducing the prophylaxis doses of TXA into our bariatric protocol (non-TXA group vs TXA group). Results Three hundred fourteen patients underwent LSG in a high-volume center from 2016 to 2017. After introducing TXA, a statistically significant reduction in the incidence of hemorrhage during surgery was observed (22.3% vs 10.8%, p = 0.006). There was a statistically significant reduction in the need for the staple line oversewing (10.2% vs 1.9%, p = 0.002). The mean operating time and the mean length of hospital stay were significantly higher in the non-TXA group than TXA group (63.1 vs 53.7 min, p < 000.1; 2.3 vs 2.1, p = 0.02). In both groups of patients, no venous thromboembolism or other complications occurred within 6 months after the surgery. Conclusions The prophylactic doses of TXA may be useful in reducing the hemorrhagic events during LSG. It may also shorten the length of hospital stay and the operating time.

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Section: Discussionmentioning

confidence: 99%

“…One of the effective methods of reducing the risk of postoperative bleeding is using tranexamic acid (TXA) [ 9 ]. It has been well described in cardiac or orthopedic surgery [ 10 , 11 ].…”

Section: Introductionmentioning

confidence: 99%

Effectiveness of prophylactic doses of tranexamic acid in reducing hemorrhagic events in sleeve gastrectomy

Lech

Michalik

Waczyński

et al. 2022

Langenbecks Arch Surg

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“…TXA has been studied in other fields as well as in other areas of urology. Other meta-analysis in orthopedics, cardiothoracic, vascular and neurosurgery as well as obstetrics have all consistently concluded benefits in bleeding and transfusion reduction without increased thrombosis risk [ 6 , 7 , 8 , 20 , 21 ]. Gong et al analyzed 529 patients undergoing lumbar interbody fusion from 7 studies.…”

Section: Discussionmentioning

confidence: 99%

“…Tranexamic (TXA) acid is a low cost synthetic lysine analog that prevents fibrin degradation by binding plasminogen. Its use in operative and postoperative bleeding reductions has been widely studied in other fields with favorable results [ 6 , 7 , 8 ]. Recently, a small number of prospective randomized controlled trials have been published comparing the results of PCNL in patients who received intra-operative TXA versus placebo.…”

Section: Introductionmentioning

confidence: 99%

Tranexamic acid vs placebo and its impact in bleeding, transfusions and stone-free rates in percutaneous nephrolithotomy: a systematic review and meta-analysis

Hinojosa-González

Flores‐Villalba

Eisner

et al. 2022

Cent european J Urol

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Introduction Percutaneous nephrolithotomy (PCNL) is the standard of care for the treatment of large renal stones. Bleeding-related complications remain a major concern when performing this procedure. Tranexamic acid (TXA) has recently been studied in both urologic and non-urologic procedures to reduce bleeding, transfusions and complications. Material and methods In June 2021 a systematic review was conducted following PRISMA guidelines on randomized prospective studies comparing the effects of TXA on bleeding complications during PCNL. Data was analyzed using Review Manager 5.3. Results Eight studies were included with a total 1,201 patients, of which 598 received TXA and 603 received placebo. TXA was associated with less bleeding (decreased change in hemoglobin) -0.79 Hb g/dl [-1.09, -0.65] p <.00001 and decreased transfusion rates (OR 0.31 [0.18, 0.52] p <0.0001). This was also associated with lower complication rates, both minor, major and overall, OR 0.59[0.41, .85] p = 0.005, OR 0.31 [0.17, 0.56] p = 0.0001 and OR 0.40 [0.29, 0.56] p <0.00001 respectively. TXA was also associated with improved stone-free rates as compared with placebo (OR 1.79 [1.23, 2.62] p = 0.003). TXA resulted in shorter operative times (11.51 minutes [-16.25, -6.77] p =.001) and length of stay (-0.74 days [-1.13 -0.34] p = 0.0006). Two pulmonary embolisms were registered in a single study in the TXA group. Conclusions In this meta-analysis, the use of TXA during PCNL was associated with a statistically significant reduction in the following parameters when compared with placebo: change in hemoglobin, transfusion rates, complication rates, operative time, and length of stay. It was also associated with improvement in stone-free rates. These data should be considered by surgeons performing PCNL.

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“…Currently, TXA is the most widely used antifibrinolytic agent, and the mainstay hemostatic agent at Fuwai Hospital. 50,[68][69][70][71][72][73] At present, the optimal doses of TXA for different cardiovascular surgical procedures and different risk groups of patients remains unknown.…”

Section: Tranexamic Acidmentioning

confidence: 99%

Patient Blood Management: Single Center Evidence and Practice at Fuwai Hospital

Yao¹,

Yuan²,

He³

et al. 2022

Chinese Medical Sciences Journal

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Blood loss and blood transfusion requirement are important quality control indicators of cardiovascular surgery and cardiovascular anesthesia. Patient blood management PBM) is an evidence-based, multidisciplinary approach to optimize the care of patients who might need transfusion, which encompasses anemia management, hemodilution, cell salvage, hemostatic treatment and other approaches to reduce bleeding as well as restriction of blood transfusion. PBM in cardiovascular surgery is a "team sport" which involves cardiac and vascular surgeons, anesthesiologists, perfusionist, intensivists, and other health care providers. The current work provides an overview of evidence and practice of PBM at Fuwai Hospital. Implementation of PBM should also take local resource availability and cost-effectiveness of different devices, drugs, technologies, and techniques into consideration.Cardiovascular surgical patients consume more than 20% of global use of

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The effect of tranexamic acid on the values of activated clotting time in patients undergoing cardiac surgery: A PRISMA-compliant systematic review and meta-analysis

Cited by 8 publications

References 27 publications

Effectiveness of prophylactic doses of tranexamic acid in reducing hemorrhagic events in sleeve gastrectomy

Effectiveness of prophylactic doses of tranexamic acid in reducing hemorrhagic events in sleeve gastrectomy

Tranexamic acid vs placebo and its impact in bleeding, transfusions and stone-free rates in percutaneous nephrolithotomy: a systematic review and meta-analysis

Patient Blood Management: Single Center Evidence and Practice at Fuwai Hospital

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