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Tranexamic acid spine surgery

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https://www.readbyqxmd.com/read/28400658/complication-rate-during-multilevel-lumbar-fusion-in-patients-above-60-years
#1
Bijjawara Mahesh, Bidre Upendra, S Vijay, Gc Arun Kumar, Srinivas Reddy
BACKGROUND: Spine surgery in elderly with comorbidities is reported to have higher complication rates and increased cost. However, the surgical outcome is good irrespective of the complications. Hence, it is essential to identify the factors affecting the complication rates in such patients and the measures to reduce them. This retrospective observational study determines the perioperative complications, their incidence and the measures to reduce complications in the elderly with comorbidities, operated by instrumented multilevel lumbar fusion...
March 2017: Indian Journal of Orthopaedics
https://www.readbyqxmd.com/read/28338491/perioperative-management-of-blood-loss-in-spine-surgery
#2
Rabia Qureshi, Varun Puvanesarajah, Amit Jain, Hamid Hassanzadeh
Spine procedures are associated with high rates of blood loss which can result in a greater need for transfusions. Repeated exposure to blood products is associated with risks and adverse reactions such as transfusion-related acute lung injury, fluid shifting, and infections. With the higher number of spine procedures and the increasing open surgery times associated with difficult procedures, excessive blood loss has become more prevalent. Perioperative methods have been established to combat the excessive blood loss and decrease the need for blood products...
March 23, 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28321954/anaphylactic-reaction-to-tranexamic-acid-in-an-adolescent-undergoing-posterior-spinal-fusion
#3
Jennifer Chiem, Iskra Ivanova, Andrew Parker, Walter Krengel, Nathalia Jimenez
Tranexamic acid is an anti-fibrinolytic agent frequently used in pediatric surgery. Common side effects include nausea, flushing, and headache, but in rare instances, it may produce anaphylaxis; with only one previously reported case in a 72-year-old man. We report a case of a delayed anaphylactic reaction in a pediatric patient undergoing posterior spine fusion; and discuss the intraoperative management of the acute event, immunologic confirmation, and subsequent anesthetic approach.
March 21, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28203735/intraoperative-tranexamic-acid-use-in-major-spine-surgery-in-adults-a-multicentre-randomized-placebo-controlled-trial%C3%A2
#4
M J Colomina, M Koo, M Basora, J Pizones, L Mora, J Bagó
Background: Perioperative tranexamic acid (TXA) use can reduce bleeding and transfusion requirements in several types of surgery, but level I evidence proving its effectiveness in major spine surgery is lacking. This study was designed to investigate the hypothesis that TXA reduces perioperative blood loss and transfusion requirements in patients undergoing major spine procedures. Methods: We conducted a multicentre, prospective, randomized double-blind clinical trial, comparing TXA with placebo in posterior instrumented spine surgery...
March 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/27885960/high-dose-tranexamic-acid-reduces-intraoperative-and-postoperative-blood-loss-in-posterior-lumbar-interbody-fusion
#5
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)...
March 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/27749350/spine-surgery-and-blood-loss-systematic-review-of-clinical-evidence
#6
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
#7
REVIEW
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...
January 2017: 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
#8
RANDOMIZED CONTROLLED TRIAL
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
#9
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
#10
REVIEW
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
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
LETTER
https://www.readbyqxmd.com/read/25868100/antifibrinolytics-reduce-blood-loss-in-adult-spinal-deformity-surgery-a-prospective-randomized-controlled-trial
#18
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
#19
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
#20
REVIEW
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
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