Tranexamic Acid Reduces Blood Loss in Total Hip Replacement Surgery

Ekbäck, Gustav; Axelsson, Kjell; Ryttberg, Lars; Edlund, Bror; Kjellberg, Jakob; Weckström, Johan; Carlsson, Olle; Schött, Ulf

doi:10.1097/00000539-200011000-00014

Cited by 84 publications

(80 citation statements)

References 19 publications

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“…From the present study and the available literature on TA in TKR and THR, the administration of TA does not seem to increase the risks of inducing thromboembolic phenomenons (total incidence of 15/305 (4.3%) with TA vs 22/345 (7.2%) with placebo). [10][11][12][13][14][15][16][17][18][19] In the present study, despite a 56.2% relative risk reduction in the number of transfused patients; there was no difference in measured blood losses. In order not to increase the risks of prosthesis infection of patients undergoing THR and TKR, surgical drains are now either rapidly removed or even avoided.…”

Section: Conclusion : L'at Ne Réduit Pas Les Pertes Sanguines Mesuréementioning

confidence: 51%

“…19 In the third study, patients were randomized to receive placebo or two iv doses of TA 10 mg·kg -1 (first dose just before the surgery) plus an infusion of 1 mg·kg -1 ·hr -1 until skin closure. 18 The authors reported a 36% decrease in measured blood losses. The number of allogenic red blood cell units transfused was not decreased but, in that study, all patients had autologous blood predonation (two units on two occasions within four weeks) plus intraoperative autotransfusion.…”

Section: Conclusion : L'at Ne Réduit Pas Les Pertes Sanguines Mesuréementioning

confidence: 95%

“…[17][18][19] In the first study, patients were randomized to receive placebo or two iv doses of TA 10 mg·kg -1 after surgery. 17 The investigators found a 62% relative risk reduction in the number of patients who required a red blood cell transfusion with TA (4/19) compared to placebo (11/20), but no difference in measured blood losses.…”

Section: Conclusion : L'at Ne Réduit Pas Les Pertes Sanguines Mesuréementioning

confidence: 99%

“…15 However, Ekbäck et al also demonstrated a lower increase in postoperative Ddimers with the administration of TA during THR, suggesting that at least part of the process may be due to the orthopedic surgery itself and/or the cement or prosthesis implantation. 18 Adherence to protocol for transfusion criteria was suboptimal. Though the predetermined transfusion trigger was observed by clinicians, once the decision to give blood products was made, the attending physician appeared to target a Hb level around 100 g·L -1 before discharge.…”

Section: Conclusion : L'at Ne Réduit Pas Les Pertes Sanguines Mesuréementioning

confidence: 99%

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L’acide tranexamique réduit les besoins de transfusion sanguine allogénique chez les patients devant subir une arthroplastie totale de la hanche

Lemay

Guay

Côté

et al. 2004

Can J Anesth/J Can Anesth

112

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Section: Conclusion : L'at Ne Réduit Pas Les Pertes Sanguines Mesuréementioning

confidence: 51%

Section: Conclusion : L'at Ne Réduit Pas Les Pertes Sanguines Mesuréementioning

confidence: 95%

Section: Conclusion : L'at Ne Réduit Pas Les Pertes Sanguines Mesuréementioning

confidence: 99%

Section: Conclusion : L'at Ne Réduit Pas Les Pertes Sanguines Mesuréementioning

confidence: 99%

See 2 more Smart Citations

L’acide tranexamique réduit les besoins de transfusion sanguine allogénique chez les patients devant subir une arthroplastie totale de la hanche

Lemay

Guay

Côté

et al. 2004

Can J Anesth/J Can Anesth

112

View full text Add to dashboard Cite

“…Tranexamic acid given at the end of the operation does not reduce postoperative bleeding in cemented THA [4]. On the contrary, tranexamic acid given preoperatively reduces intraoperative and postoperative bleeding in cemented THA [9]. However, there were no reports on perioperative bleeding in cementless THA using tranexamic acid.…”

Section: Introductionmentioning

confidence: 99%

Tranexamic acid reduces blood loss after cementless total hip arthroplasty?prospective randomized study in 40 cases

Yamasaki¹,

Masuhara²,

Fuji³

2004

International Orthopaedics

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Association of Intravenous Tranexamic Acid With Thromboembolic Events and Mortality

et al. 2021

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IMPORTANCE Tranexamic acid (TXA) is an efficient antifibrinolytic agent; however, concerns remain about the potential adverse effects, particularly vascular occlusive events, that may be associated with its use.OBJECTIVE To examine the association between intravenous TXA and total thromboembolic events (TEs) and mortality in patients of all ages and of any medical disciplines.DATA SOURCE Cochrane Central Register of Controlled Trials and MEDLINE were searched for eligible studies investigating intravenous TXA and postinterventional outcome published between 1976 and 2020.STUDY SELECTION Randomized clinical trials comparing intravenous TXA with placebo/no treatment. The electronic database search yielded a total of 782 studies, and 381 were considered for full-text review. Included studies were published in English, German, French, and Spanish. Studies with only oral or topical tranexamic administration were excluded.DATA EXTRACTION AND SYNTHESIS Meta-analysis, subgroup and sensitivity analysis, and meta-regression were performed. This study followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) reporting guideline. MAIN OUTCOMES AND MEASURES Vascular occlusive events and mortality.RESULTS A total of 216 eligible trials including 125 550 patients were analyzed. Total TEs were found in 1020 (2.1%) in the group receiving TXA and 900 (2.0%) in the control group. This study found no association between TXA and risk for total TEs (risk difference = 0.001; 95% CI, −0.001 to 0.002; P = .49) for venous thrombosis, pulmonary embolism, venous TEs, myocardial infarction or ischemia, and cerebral infarction or ischemia. Sensitivity analysis using the risk ratio as an effect measure with (risk ratio = 1.02; 95% CI, 0.94-1.11; P = .56) and without (risk ratio = 1.03; 95% CI, 0.95-1.12; P = .52) studies with double-zero events revealed robust effect size estimates. Sensitivity analysis with studies judged at low risk for selection bias showed similar results. Administration of TXA was associated with a significant reduction in overall mortality and bleeding mortality but not with nonbleeding mortality. In addition, an increased risk for vascular occlusive events was not found in studies including patients with a history of thromboembolism. Comparison of studies with sample sizes of less than or equal to 99 (risk difference = 0.004; 95% CI, −0.006 to 0.014; P = .40), 100 to 999 (risk difference = 0.004; 95% CI, −0.003 to 0.011; P = .26), and greater than or equal to 1000 (risk difference = −0.001; 95% CI, −0.003 to 0.001; P = .44) showed no association between TXA and incidence of total TEs. Meta-regression of 143 intervention groups showed no association between TXA dosing and risk for venous TEs (risk difference, −0.005; 95% CI, −0.021 to 0.011; P = .53).CONCLUSIONS AND RELEVANCE Findings from this systematic review and meta-analysis of 216 studies suggested that intravenous TXA, irrespective of dosing, is not associated with increased risk of any TE. These results help clarify the incidence of...

show abstract

Tranexamic Acid Reduces Blood Loss in Total Hip Replacement Surgery

Cited by 84 publications

References 19 publications

L’acide tranexamique réduit les besoins de transfusion sanguine allogénique chez les patients devant subir une arthroplastie totale de la hanche

L’acide tranexamique réduit les besoins de transfusion sanguine allogénique chez les patients devant subir une arthroplastie totale de la hanche

Tranexamic acid reduces blood loss after cementless total hip arthroplasty?prospective randomized study in 40 cases

Association of Intravenous Tranexamic Acid With Thromboembolic Events and Mortality

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