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Tranexamic acid spine surgery

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https://www.readbyqxmd.com/read/27885960/high-dose-tranexamic-acid-reduces-intraoperative-and-postoperative-blood-loss-in-posterior-lumbar-interbody-fusion
#1
Junichi Kushioka, Tomoya Yamashita, Shinya Okuda, Takafumi Maeno, Tomiya Matsumoto, Ryoji Yamasaki, Motoki Iwasaki
OBJECTIVE Tranexamic acid (TXA), a synthetic antifibrinolytic drug, has been reported to reduce blood loss in orthopedic surgery, but there have been few reports of its use in spine surgery. Previous studies included limitations in terms of different TXA dose regimens, different levels and numbers of fused segments, and different surgical techniques. Therefore, the authors decided to strictly limit TXA dose regimens, surgical techniques, and fused segments in this study. There have been no reports of using TXA for prevention of intraoperative and postoperative blood loss in posterior lumbar interbody fusion (PLIF)...
November 25, 2016: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/27749350/spine-surgery-and-blood-loss-systematic-review-of-clinical-evidence
#2
Dafna Willner, Valeria Spennati, Shelly Stohl, Giulia Tosti, Simone Aloisio, Federico Bilotta
Spine surgery has been growing rapidly as a neurosurgical operation, with an increase of 220% over a 15-year period. Intraoperative blood transfusion is a major outcome determinant of spine procedures. Various approaches, including pharmacologic and nonpharmacologic therapies, have been tested to decrease both intraoperative and postoperative blood loss. The aim of this systematic review is to report clinical evidence on the relationship between intraoperative blood loss (primary outcome) and on transfusion requirements and postoperative complications (secondary outcomes) in patients undergoing spine surgery...
November 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27671279/efficacy-of-antifibrinolytic-agents-on-surgical-bleeding-and-transfusion-requirements-in-spine-surgery-a-meta-analysis
#3
Guang Li, Tian-Wei Sun, Gan Luo, Chao Zhang
PURPOSE: Spine surgery is usually associated with large amount of blood loss and blood transfusion. Excessive blood loss may cause hypotension, inadequate oxygenation of organs, necessitate allogeneic blood transfusion, and spinal epidural hematoma formation. Aprotinin, TXA, and EACA are antifibrinolytics currently offered as prophylactic agents to reduce surgery-associated blood loss. The purpose of this study was to assess the efficacy of using antifibrinolytic agents in reducing blood loss and blood transfusions in spine surgery...
September 26, 2016: European Spine Journal
https://www.readbyqxmd.com/read/27343711/using-tranexamic-acid-soaked-absorbable-gelatin-sponge-following-complex-posterior-lumbar-spine-surgery-a-randomized-control-trial
#4
Jinqian Liang, Hongzhe Liu, Xiangwang Huang, Wei Xiong, Hong Zhao, Sooyong Chua, Zheng Li
OBJECTIVES: This paper aims to determine whether the use of Tranexemic Acid (TXA) - soaked absorbable gelatin sponge could more effectively reduce post-operative blood loss and blood transfusion requirements among low-risk adult patients undergoing lumbar spine surgery. METHODS: A total of 90 consecutive patients undergoing surgery for multilevel posterior lumbar degenerative procedures were prospectively randomized into one of three groups: - TXA Soaked Gelfoam group, absorbable gelatin sponge group or control group...
August 2016: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/27099820/systemic-and-topical-use-of-tranexamic-acid-in-spinal-surgery-a-systematic-review
#5
REVIEW
Sebastian F Winter, Carlo Santaguida, Jean Wong, Michael G Fehlings
Study Design Combination of narrative and systematic literature reviews. Objectives Massive perioperative blood loss in complex spinal surgery often requires blood transfusions and can negatively affect patient outcome. Systemic use of the antifibrinolytic agent tranexamic acid (TXA) has become widely used in the management of surgical bleeding. We review the clinical evidence for the use of intravenous TXA as a hemostatic agent in spinal surgery and discuss the emerging role for its complementary use as a topical agent to reduce perioperative blood loss from the surgical site...
May 2016: Global Spine Journal
https://www.readbyqxmd.com/read/26942474/safety-efficacy-and-cost-effectiveness-of-tranexamic-acid-in-orthopedic-surgery
#6
Zilan X Lin, Shane K Woolf
Perioperative bleeding and postsurgical hemorrhage are common in invasive surgical procedures, including orthopedic surgery. Tranexamic acid (TXA) is a pharmacologic agent that acts through an antifibrinolytic mechanism to stabilize formed clots and reduce active bleeding. It has been used successfully in orthopedics to reduce perioperative blood loss, particularly in total hip and knee arthroplasty and spine surgery. Numerous research studies have reported favorable safety and efficacy in orthopedic cases, although there is no universal standard on its administration and its use has not yet become the standard of practice...
March 2016: Orthopedics
https://www.readbyqxmd.com/read/26614928/application-of-tranexamic-acid-in-trauma-and-orthopedic-surgery
#7
REVIEW
John D Jennings, Mark K Solarz, Christopher Haydel
Tranexamic acid has gained recent interest in orthopedics and trauma surgery because of its demonstrated benefit in several clinical trials. It is inexpensive and effective at reducing blood loss and blood transfusion requirements without a significant increase in morbidity or mortality. The optimal timing, dosing, and route of administration in orthopedics are yet to be elucidated. Significant investigation of tranexamic acid use in joint replacement and spine surgery has promoted its incorporation into the everyday practice of many of these surgeons...
January 2016: Orthopedic Clinics of North America
https://www.readbyqxmd.com/read/26523960/left-ventricle-thrombus-after-tranexamic-acid-for-spine-surgery-in-an-hiv-positive-patient
#8
Neal Stuart Gerstein, Janet Kathryn Brierley, Matthew Douglas Culling
BACKGROUND CONTEXT: Our case highlights the underappreciated thrombotic risks of tranexamic acid (TXA) use in non-cardiac surgery and emphasizes the need to elucidate these risks with appropriate clinical trials. PURPOSE: The use of TXA in non-cardiac surgery has significantly expanded in the past 5 years, especially after the 2010 publication of the CRASH-2 Trial. We submit a case with the intent to highlight the thrombotic risk of TXA use during non-cardiac surgery and discuss the need for careful risk stratification before the use of TXA in this context...
February 2016: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/26382761/efficacy-and-safety-of-antifibrinolytic-agents-in-reducing-perioperative-blood-loss-and-transfusion-requirements-in-scoliosis-surgery-a-systematic-review-and-meta-analysis
#9
REVIEW
Meng Wang, Xin-Feng Zheng, Lei-Sheng Jiang
BACKGROUND: Routine use of antifibrinolytic agents in spine surgery is still an issue of debate. OBJECTIVE: To gather scientific evidence for the efficacy and safety of antifibrinolytic agents including aprotinin, tranexamic acid (TXA) and epsilon aminocaproic acid (EACA, traditionally known as Amicar) in reducing perioperative blood loss and transfusion requirements in scoliosis surgery. METHODS: We conducted a systematic review and meta-analysis for randomized controlled trials (RCTs), retrospective case-control studies, and retrospective cohort studies on the use of antifibrinolytic agents in scoliosis surgery by searching in the MEDLINE and EMBASE databases and the Cochrane Database of Systematic Reviews and Controlled Trials of papers published from January 1980 through July 2014...
2015: PloS One
https://www.readbyqxmd.com/read/26346761/aminocaproic-acid-administration-is-associated-with-reduced-perioperative-blood-loss-and-transfusion-in-pediatric-craniofacial-surgery
#10
G Hsu, J A Taylor, J E Fiadjoe, A M Vincent, E Y Pruitt, S P Bartlett, P A Stricker
BACKGROUND: Severe blood loss is a common complication of craniofacial reconstruction surgery. The antifibrinolytic ε-aminocaproic acid (EACA) reduces transfusion requirements in children undergoing cardiac surgery and in older children undergoing spine surgery. Tranexamic acid (TXA), another antifibrinolytic with a similar mechanism of action, has been shown to reduce blood loss and transfusion requirements in children undergoing craniofacial surgery. However, TXA has been associated with an increase in post-operative seizures and is more expensive than EACA...
February 2016: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/26208230/two-doses-of-tranexamic-acid-reduce-blood-transfusion-in-complex-spine-surgery-a-prospective-randomized-study
#11
RANDOMIZED CONTROLLED TRIAL
Manee Raksakietisak, Benjabhorn Sathitkarnmanee, Peeranat Srisaen, Tithiganya Duangrat, Thitima Chinachoti, Pranee Rushatamukayanunt, Nuchanat Sakulpacharoen
STUDY DESIGN: Prospective, double-blinded, randomized controlled study. OBJECTIVE: To determine whether the use of 2 doses of tranexamic acid (TXA) can reduce perioperative blood loss and blood transfusions in low-risk adult patients undergoing complex laminectomy. SUMMARY OF BACKGROUND DATA: Complex laminectomy (multilevel laminectomy or laminectomy and instrumentation) is a procedure with a medium risk of blood loss, which may require allogeneic blood transfusion...
December 2015: Spine
https://www.readbyqxmd.com/read/26053893/rotational-thromboelastometry-guided-blood-product-management-in-major-spine-surgery
#12
Bhiken I Naik, Thomas N Pajewski, David I Bogdonoff, Zhiyi Zuo, Pamela Clark, Abdullah S Terkawi, Marcel E Durieux, Christopher I Shaffrey, Edward C Nemergut
OBJECT Major spinal surgery in adult patients is often associated with significant intraoperative blood loss. Rotational thromboelastometry (ROTEM) is a functional viscoelastometric method for real-time hemostasis testing. In this study, the authors sought to characterize the coagulation abnormalities encountered in spine surgery and determine whether a ROTEM-guided, protocol-based approach to transfusion reduced blood loss and blood product use and cost. METHODS A hospital database was used to identify patients who had undergone adult deformity correction spine surgery with ROTEM-guided therapy...
August 2015: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/25940567/answer-to-the-letter-to-the-editor-of-g-liao-et-al-concerning-is-tranexamic-acid-effective-and-safe-in-spinal-surgery-a-meta-analysis-of-randomized-controlled-trials-by-li-zj-fu-x-xing-d-zhang-hf-zang-jc-ma-xl-2013-eur-spine-j-22-9-1950-7
#13
LETTER
https://www.readbyqxmd.com/read/25868100/antifibrinolytics-reduce-blood-loss-in-adult-spinal-deformity-surgery-a-prospective-randomized-controlled-trial
#14
RANDOMIZED CONTROLLED TRIAL
Austin Peters, Kushagra Verma, Kseniya Slobodyanyuk, Thomas Cheriyan, Christian Hoelscher, Frank Schwab, Baron Lonner, Tessa Huncke, Virginie Lafage, Thomas Errico
STUDY DESIGN: This is a prospective, randomized, double-blinded comparison of tranexamic acid (TXA), epsilon aminocaproic acid (EACA), and placebo used intraoperatively in patients with adult spinal deformity. OBJECTIVE: The purpose of this study was to provide high-quality evidence regarding the comparative efficacies of TXA, EACA, and placebo in reducing blood loss and transfusion requirements in patients undergoing posterior spinal fusion surgery. SUMMARY OF BACKGROUND DATA: Spine deformity surgery usually involves substantial blood loss...
April 15, 2015: Spine
https://www.readbyqxmd.com/read/25617507/efficacy-of-tranexamic-acid-on-surgical-bleeding-in-spine-surgery-a-meta-analysis
#15
Thomas Cheriyan, Stephen P Maier, Kristina Bianco, Kseniya Slobodyanyuk, Rachel N Rattenni, Virginie Lafage, Frank J Schwab, Baron S Lonner, Thomas J Errico
BACKGROUND CONTEXT: Spine surgery is usually associated with large amount of blood loss, necessitating blood transfusions. Blood loss-associated morbidity can be because of direct risks, such as hypotension and organ damage, or as a result of blood transfusions. The antifibrinolytic, tranexamic acid (TXA), is a lysine analog that inhibits activation of plasminogen and has shown to be beneficial in reducing surgical blood loss. PURPOSE: To consolidate the findings of randomized controlled trials (RCTs) investigating the use of TXA on surgical bleeding in spine surgery...
April 1, 2015: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/25458625/a-systematic-review-of-the-effectiveness-of-intravenous-tranexamic-acid-administration-in-managing-perioperative-blood-loss-in-patients-undergoing-spine-surgery
#16
Jennifer Badeaux, Diane Hawley
This systematic review aimed to identify the effectiveness of intravenous tranexamic acid (TXA) administration in managing perioperative blood loss in patients undergoing spine surgery. The study design was a systematic review and meta-analysis. Quantitative articles were pooled in a statistical meta-analysis using the Joanna Briggs Institute Meta-Analysis of Statistical Assessment and Review Instrument. Twelve studies totaling 934 participants carried out between 1960 and 2013 were included in the review. Intraoperative blood loss showed statistically significant (P < ...
December 2014: Journal of Perianesthesia Nursing: Official Journal of the American Society of PeriAnesthesia Nurses
https://www.readbyqxmd.com/read/25457470/preliminary-investigation-of-high-dose-tranexamic-acid-for-controlling-intraoperative-blood-loss-in-patients-undergoing-spine-correction-surgery
#17
Jingming Xie, Lawrence G Lenke, Tao Li, Yongyu Si, Zhi Zhao, Yingsong Wang, Ying Zhang, Jie Xiao
BACKGROUND CONTEXT: With a significant increase in the number and complexity of spinal deformity corrective surgeries, blood loss, often requiring massive intraoperative transfusions, becomes a major limiting factor during surgery. This scenario is particularly during posterior vertebral column resection (PVCR), where extensive intraoperative blood loss may pose a major risk to the patient, preventing smooth execution of the procedure. Tranexamic Acid (TXA) has been used in cardiac and orthopedic surgeries, including major spinal surgeries, to reduce blood loss and transfusion requirements for decades...
April 1, 2015: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/25391883/-improve-of-surgical-outcomes-in-spinal-fusion-surgery-evidence-based-peri-and-intra-operative-aspects-to-reduce-complications-and-earlier-recovery
#18
C Fleege, A Almajali, M Rauschmann, M Rickert
OBJECTIVES: Because international data have a low level of evidence, a variety of treatment approaches for lumbar spine fusion operations are justified based on long-established or safety aspects. The aim of this work is to present an overview of evidence-based peri- and intraoperative treatment measures to shorten the recovery and increase patient satisfaction. MATERIALS AND METHODS: This review article is based on a selective literature search that also included PubMed on peri- and intraoperative treatment measures for lumbar spinal surgery...
December 2014: Der Orthopäde
https://www.readbyqxmd.com/read/24557107/the-efficacy-of-antifibrinolytic-drugs-in-children-undergoing-noncardiac-surgery-a-systematic-review-of-the-literature
#19
REVIEW
David Faraoni, Susan M Goobie
Children undergoing major surgery are frequently exposed to a high risk of blood loss often requiring transfusion. Although the risks associated with blood product transfusion have considerably decreased over the last decade, transfusion is still associated with significant morbidity and mortality. Thus, rigorous efforts should be made to decrease surgical bleeding and the need for blood product transfusion. Antifibrinolytic drugs have been shown to be effective when used in both adult and pediatric surgical patients...
March 2014: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/24432083/the-effect-of-tranexamic-acid-in-blood-loss-and-transfusion-volume-in-adolescent-idiopathic-scoliosis-surgery-a-single-surgeon-experience
#20
Marios G Lykissas, Alvin H Crawford, Gilbert Chan, Lori A Aronson, Mohammed J Al-Sayyad
PURPOSE: Intraoperative blood loss in scoliosis surgery often requires transfusions. Autogenous blood decreases but does not eliminate risks typically associated with allogenic blood transfusion. Costs associated with transfusions are significant. Tranexamic acid (TXA) has been shown to decrease blood loss in cardiac and joint surgery. Few studies have examined its use in pediatric spine surgery, and the results are inconsistent. The aim of this study was to determine whether TXA decreases intraoperative blood loss and transfusion requirements in adolescent idiopathic scoliosis patients undergoing posterior spinal fusion by a single surgeon...
June 2013: Journal of Children's Orthopaedics
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