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Tranexamic Acid

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https://www.readbyqxmd.com/read/29662786/comparison-of-topical-and-intravenous-administration-of-tranexamic-acid-for-blood-loss-control-during-total-joint-replacement-review-of-literature
#1
REVIEW
Georgi P Georgiev, Panayot P Tanchev, Zlatka Zheleva, Plamen Kinov
Purpose: Many randomised controlled trials and meta-analysis studies have presented the efficacy of tranexamic acid (TXA) without an increase of complications. However, questions still remain about the type of administration, optimal dose and secondary outcomes of TXA in total hip arthroplasty and total knee arthroplasty. The aim of this review is to summarise the existing information in literature concerning the pharmacological characteristics of TXA, forms, doses, types of application and contraindications for its use...
April 2018: Journal of Orthopaedic Translation
https://www.readbyqxmd.com/read/29657445/tranexamic-acid-in-total-hip-arthroplasty-mixed-treatment-comparisons-of-randomized-controlled-trials-and-cohort-studies
#2
Kannan Sridharan, Gowri Sivaramakrishnan
Background: The present study is a network meta-analysis of various routes of tranexamic acid (TXA) in patients with total hip arthroplasty (THA). Methods: Randomized controlled trials and cohort studies evaluating TXA in patients with THA were included. Number of patients requiring blood transfusion was the primary outcome. Results: Pooled estimate for TXA use against placebo for blood transfusion rate was 0.30 [0.23, 0.39] favoring TXA. Maximum reduction in the risk of blood transfusion was observed with topical plus intra-operative intravenous TXA...
March 2018: Journal of Orthopaedics
https://www.readbyqxmd.com/read/29656433/antifibrinolytics-for-heavy-menstrual-bleeding
#3
REVIEW
Alison C Bryant-Smith, Anne Lethaby, Cindy Farquhar, Martha Hickey
BACKGROUND: Heavy menstrual bleeding (HMB) is an important physical and social problem for women. Oral treatment for HMB includes antifibrinolytic drugs, which are designed to reduce bleeding by inhibiting clot-dissolving enzymes in the endometrium.Historically, there has been some concern that using the antifibrinolytic tranexamic acid (TXA) for HMB may increase the risk of venous thromboembolic disease. This is an umbrella term for deep venous thrombosis (blood clots in the blood vessels in the legs) and pulmonary emboli (blood clots in the blood vessels in the lungs)...
April 15, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29652744/clinical-pearls-part-3-anaesthetic-management-of-abnormally-invasive-placentation
#4
Vinod Patil, Gamunu Ratnayake, Galina Fastovets, D S Wijayatilake
PURPOSE OF REVIEW: Abnormal placentation is a clinical condition seen increasingly in the pregnant population. It is associated with significant morbidity and mortality, which may be mitigated through robust multidisciplinary care for these patients. The role of maternal critical care for these patients has largely been ignored in the literature. RECENT FINDINGS: Advances in pharmacological management of bleeding with recent publications of large multicentre trials in addition to new technologies in the management of massive obstetric haemorrhage (MOH) have revolutionized the management of abnormal placentation...
April 12, 2018: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/29652688/acute-coronary-artery-thrombus-after-tranexamic-acid-during-total-shoulder-arthroplasty-in-a-patient-with-coronary-stents-a-case-report
#5
Kathryn H Bridges, Sylvia H Wilson
Tranexamic acid (TXA), an antifibrinolytic, is routinely used to decrease transfusion rates in total joint replacement surgery. While recent publications have indicated a low risk of TXA-associated thromboembolic events in this orthopedic population, few studies specifically address the safety of TXA administration in high-risk patients. We present a case of acute coronary thrombus requiring emergent intervention in a patient with indwelling coronary stents who underwent shoulder arthroplasty with TXA administration...
April 15, 2018: A&A practice
https://www.readbyqxmd.com/read/29630007/optimizing-blood-transfusion-practices-through-bundled-intervention-implementation-in-patients-with-gynecologic-cancer-undergoing-laparotomy
#6
Sumer K Wallace, Jessica W Halverson, Christopher J Jankowski, Stephanie R DeJong, Amy L Weaver, Megan R Weinhold, Bijan J Borah, James P Moriarty, William A Cliby, Daryl J Kor, Andrew A Higgins, Hilary A Otto, Sean C Dowdy, Jamie N Bakkum-Gamez
OBJECTIVE: To examine blood transfusion practices and develop a standardized bundle of interventions to address the high rate of perioperative red blood cell transfusion among patients with ovarian and endometrial cancer. METHODS: This was a retrospective cohort study. Our primary aim was to determine whether an implemented bundled intervention was associated with a reduction in perioperative red blood cell transfusions among cases of laparotomy for cancer. Secondary aims included comparing perioperative demographic, surgical, complication, and cost data...
April 6, 2018: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29627368/supportive-topical-tranexamic-acid-application-for-hemostasis-in-oral-bleeding-events-retrospective-cohort-study-of-542-patients
#7
Matthias Zirk, Max Zinser, Johannes Buller, Viktor Bilinsky, Timo Dreiseidler, Joachim E Zöller, Matthias Kreppel
PURPOSE: Tranexamic acid (TXA) is widely used in the prevention of postsurgical oral bleeding. Tranexamic acid in addition to further surgical measures is widely utilized in prevention of post-surgical oral bleeding. The aim of the present study was to investigate: Can oral hemostasis be achieved by merely compression and topical application of tranexamic acid in different anticoagulant regimes among patients attending a general emergency department? Where are the limits to this procedure? Which has the greater impact on surgeons' choice for an invasive hemostatic approach-bleeding quality or oral anticoagulant therapy? MATERIALS AND METHODS: A retrospective cohort study of 542 patients who consecutively received treatment for oral bleeding was performed...
March 20, 2018: Journal of Cranio-maxillo-facial Surgery
https://www.readbyqxmd.com/read/29624770/hot-off-the-press-topical-tranexamic-acid-compared-with-anterior-nasal-packing-for-treatment-of-epistaxis-in-patients-taking-antiplatelet-drugs
#8
Justin Morgenstern, Sahaana Rangarajan, Corey Heitz, Chris Bond, William K Milne
This is a non-blinded, randomized controlled trial comparing topical TXA and anterior nasal packing in the treatment of anterior epistaxis in patients on antiplatelet medications whose bleeding persisted despite 20 minutes of pressure. Patients were randomized to either TXA (a cotton pledget soaked with 500 mg of TXA and inserted into the affected nostril until hemostasis was achieved) or anterior nasal packing (pretreatment with a cotton pledget soaked in epinephrine and 2% lidocaine for 10 minutes followed by anterior nasal packing with tetracycline ointment left in situ for 3 days)...
April 6, 2018: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/29615381/hyperfibrinolysis-diagnosed-with-rotational-thromboelastometry-and-treated-with-tranexamic-acid-in-a-dog-with-acute-traumatic-coagulopathy
#9
B Muri, P Schmierer, A Schwarz, N Sigrist
A 4-year old male Australian Cattle Dog involved in a road traffic accident was presented with severe polytrauma to the Small Animal Clinic, University of Zurich. He was presented in hemorrhagic shock, with an initial lactate of 10.3mmol/l and ongoing bleeding from multiple injury sites. Acute traumatic coagulopathy diagnosed with ROTEM within one hour after accident showed marked hypocoagulation and hyperfibrinolysis. Treatment with a total dose of 40mg/kg of tranexamic acid intravenously resulted in successful elimination of hyperfibrinolysis in the following, serially measured ROTEM tracings...
April 2018: Schweizer Archiv Für Tierheilkunde
https://www.readbyqxmd.com/read/29605152/pharmacologic-hemostatic-agents-in-total-joint-arthroplasty-a-cost-effectiveness-analysis
#10
Dipak B Ramkumar, Niveditta Ramkumar, Stephanie J Tapp, Wayne E Moschetti
BACKGROUND: Total knee and hip arthroplasties can be associated with substantial blood loss, affecting morbidity and even mortality. Two pharmacological antifibrinolytics, ε-aminocaproic acid (EACA) and tranexamic acid (TXA) have been used to minimize perioperative blood loss, but both have associated morbidity. Given the added cost of these medications and the risks associated with then, a cost-effectiveness analysis was undertaken to ascertain the best strategy. METHODS: A cost-effectiveness model was constructed using the payoffs of cost (in United States dollars) and effectiveness (quality-adjusted life expectancy, in days)...
March 3, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29602670/topical-tranexamic-acid-for-the-treatment-of-acute-epistaxis-in-the-emergency-department
#11
Asha R Birmingham, Nathan D Mah, Ran Ran, Matthew Hansen
OBJECTIVE: To evaluate the effectiveness and potential benefits of topical tranexamic acid (TXA) in the management of acute epistaxis. METHODS: Retrospective review was performed among all patients presenting to the institution's emergency department (ED) with epistaxis between September 2014 and August 2016. Patients achieving hemostasis with standard of care agents, such as oxymetazoline, lidocaine, or epinephrine were excluded. The primary outcome was the ED length of stay (LOS)...
March 21, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29600682/-a-case-report-of-tranexamic-acid-associated-epilepsy-in-spine-surgery
#12
Li-Jun Gu, Hong-Mei Zhang, Bin Zhang, Tie-Jun Zhao, Peng-Cheng Shan, Ming-Jiang He
No abstract text is available yet for this article.
March 25, 2018: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
https://www.readbyqxmd.com/read/29594528/comparing-the-efficacy-of-intravenous-or-intra-articular-tranexamic-acid-in-reducing-blood-loss-in-simultaneous-bilateral-knee-replacement-surgery-without-the-use-of-tourniquet
#13
Mridul Arora, Saurabh Singh, Varun Gupta, Ashutosh Dongre, Vijay Shetty
PURPOSE: To compare the effect of intravenous or intra-articular route of administration of tranexamic acid in reducing the blood loss in simultaneous bilateral total knee replacement surgeries performed without the use of tourniquets. METHODS: Prospective cohort study of 30 consecutive patients grouped into two groups; Group 1: intravenous group and group 2: intra-articular group. Two outcome measures were studied; mean drop in post-operative haemoglobin and need for blood transfusion in both groups...
March 29, 2018: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/29594527/matched-cohort-study-of-topical-tranexamic-acid-in-cementless-primary-total-hip-replacement
#14
Javier Sanz-Reig, Jesus Mas Martinez, Carmen Verdu Román, Manuel Morales Santias, Enrique Martínez Gimenez, David Bustamante Suarez de Puga
PURPOSE: Tranexamic acid has been shown to be effective in reducing blood loss after total hip replacement. The purpose of this study was to prospectively assess the effectiveness of topical TXA use to reduce blood loss after primary total hip replacement and to compare these outcomes with those of a matched control group from a similar cohort that did not have received tranexamic acid. METHODS: This is a prospective matched control study to assess the effect of a 2 g topical tranexamic acid in 50 mL physiological saline solution in total hip replacement...
March 29, 2018: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/29589496/is-tranexamic-acid-toxic-to-articular-cartilage-when-administered-topically
#15
J D Parker, K S Lim, D C Kieser, T B F Woodfield, G J Hooper
Aims The intra-articular administration of tranexamic acid (TXA) has been shown to be effective in reducing blood loss in unicompartmental knee arthroplasty and anterior cruciate reconstruction. The effects on human articular cartilage, however, remains unknown. Our aim, in this study, was to investigate any detrimental effect of TXA on chondrocytes, and to establish if there was a safe dose for its use in clinical practice. The hypothesis was that TXA would cause a dose-dependent damage to human articular cartilage...
March 1, 2018: Bone & Joint Journal
https://www.readbyqxmd.com/read/29576638/is-combined-administration-of-tranexamic-acid-better-than-both-intravenous-and-topical-regimes-for-total-loss-hidden-loss-and-post-operative-swelling-a-randomized-control-trial
#16
Jatin Prakash, Jong-Keun Seon, Eun-Kyoo Song, Dong-Hyun Lee, Hong-Yeol Yang, Cheng Jin
Background: Bleeding is one of the unavoidable complications of total knee arthroplasty (TKA). Tranexamic acid (TXA) in last decade has emerged as an effective and safe way to decrease postoperative bleeding and transfusion rates. Although there is little doubt on the efficacy of the drug, the debate on ideal mode is more recent. We undertook this study to find out the most effective and yet safest way of TXA administration. Materials and Methods: A single institution - two hospital-based, double-blinded, prospective, randomized control trial was conducted from January 2015 to December 2015...
March 2018: Indian Journal of Orthopaedics
https://www.readbyqxmd.com/read/29573898/efficacy-of-prehospital-administration-of-tranexamic-acid-in-trauma-patients-a-meta-analysis-of-the-randomized-controlled-trials
#17
REVIEW
Ayman El-Menyar, Brijesh Sathian, Mohammed Asim, Rifat Latifi, Hassan Al-Thani
OBJECTIVE: Antifibrinolytic agent tranexamic acid (TXA) has a potential clinical benefit for in-hospital patients with severe bleeding but its effectiveness in pre-hospital settings remains unclear. We conducted a systematic review and meta-analysis to evaluate whether pre-hospital administration of TXA compared to placebo improve patients' outcomes? METHODS: PubMed, MEDLINE, Cochrane Library, WHO International Clinical Trials Registry Platform, Cochrane Central Register of Controlled Trials (CENTRAL), Scopus, clinicaltrials...
March 16, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29567052/the-efficacy-and-safety-of-topical-tranexamic-acid-a-systematic-review-and-meta-analysis
#18
REVIEW
Joshua Montroy, Brian Hutton, Preveshen Moodley, Nicholas A Fergusson, Wei Cheng, Alan Tinmouth, Luke T Lavallée, Dean A Fergusson, Rodney H Breau
Tranexamic acid (TXA) is an effective hemostatic agent used for the reduction of blood loss and transfusion. However, the safety profile of TXA remains in question due to a potential increased risk of venous thromboembolism. By applying TXA topically as opposed to intravenously, systemic absorption may be reduced and unwanted side-effects mitigated. The objective of our review is to investigate the efficacy and safety of topically applied tranexamic acid compared to both placebo, and the intravenous administration...
February 19, 2018: Transfusion Medicine Reviews
https://www.readbyqxmd.com/read/29560401/a-prospective-randomized-comparative-study-of-intravenous-alone-and-combined-intravenous-and-intraarticular-administration-of-tranexamic-acid-in-primary-total-knee-replacement
#19
Paolo Adravanti, Eleonora Di Salvo, Giuseppe Calafiore, Sebastiano Vasta, Aldo Ampollini, Michele Attilio Rosa
Background: Studies on the use of tranexamic acid (TXA) to improve clinical outcomes after joint arthroplasty have reported contrasting results between intravenous (IV) TXA alone and combined IV and intraarticular (IA) administration. We compared the effectiveness of the 2 methods in providing higher postoperative hemoglobin (Hb) levels in patients undergoing primary total knee arthroplasty (TKA). Methods: A total of 100 TKA patients were randomly assigned to receive either IV TXA alone (group 1) or combined IV and topical IA TXA (group 2)...
March 2018: Arthroplasty Today
https://www.readbyqxmd.com/read/29560399/tranexamic-acid-increases-early-perioperative-functional-outcomes-after-total-knee-arthroplasty
#20
Matthew J Grosso, David P Trofa, Jonathan R Danoff, Thomas R Hickernell, Taylor Murtaugh, Akshay Lakra, Jeffrey A Geller
Background: The purpose of this study was to investigate the influence of tranexamic acid (TXA) on functional outcomes in the immediate postoperative period after total knee arthroplasty (TKA). We hypothesized that the known benefits of TXA would confer measurable clinical improvements in physical therapy (PT) performance, decrease pain, and decrease hospital length of stay (LOS). Methods: We retrospectively analyzed 560 TKA patients, including 280 consecutive patients whose surgery was performed before the initiation of a standardized TXA protocol and the first 280 patients who received TXA after protocol initiation...
March 2018: Arthroplasty Today
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