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https://www.readbyqxmd.com/read/28328682/early-tranexamic-acid-administration-ameliorates-the-endotheliopathy-of-trauma-and-shock-in-an-in-vitro-model
#1
Lawrence N Diebel, Jonathan V Martin, David M Liberati
BACKGROUND: Systemic vascular endothelial injury is a consequence of trauma-hemorrhagic shock (T/HS) which results in disturbances of coagulation, inflammation and endothelial barrier integrity. The effect of T/HS on the endothelium (Endotheliopathy of Trauma)[EoT] is of intense research interest and may lead to EoT directed therapies. Administration of tranexamic acid (TXA) in trauma patients is associated with a survival benefit and fewer complications if given early after injury. Mechanisms for this protective effect include the anti-fibrinolytic and anti-inflammatory effects of TXA...
March 21, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28326403/effects-of-tranexamic-acid-and-bipolar-sealer-alone-or-in-combination-in-primary-total-knee-arthroplasty-a-prospective-randomized-controlled-trial
#2
Alexandru Seviciu, Irwin Gross, Samreen Fathima, Stephen M Walsh
BACKGROUND: The purpose of this study was to compare 2 blood management interventions, tranexamic acid (TXA) and bipolar sealer system (BSS) used independently or in combination with a control group during primary total knee arthroplasty (TKA). METHODS: A total of 127 TKA patients were enrolled and randomized into 4 groups: Intravenous TXA plus the BSS (N = 29, group 1); TXA only (N = 29, group 2); BSS only (N = 31, group 3); and intravenous normal saline as a control group (N = 32, group 4)...
June 2016: Arthroplasty Today
https://www.readbyqxmd.com/read/28316839/tranexamic-acid-txa-in-trauma-patients-barriers-to-use-among-trauma-surgeons-and-emergency-physicians
#3
Abdulaziz Alburaih
Objective. Tranexamic Acid (TXA) is currently the only drug with prospective clinical evidence supporting its use in bleeding trauma patients. We sought to better understand the barriers preventing its use and elicit suggestions to further its use in trauma patients in the state of Maryland. Methods. This is a cross-sectional study. Results. The overall response rate was 38%. Half of all participants reported being familiar with the CRASH-2 trial and MATTERs study. Half reported being aware of TXA as part of their institution's massive transfusion protocol...
2017: Emergency Medicine International
https://www.readbyqxmd.com/read/28282425/administration-of-tranexamic-acid-to-patients-undergoing-surgery-for-adolescent-idiopathic-scoliosis-evokes-pain-and-increases-the-infusion-rate-of-remifentanil-during-the-surgery
#4
Nobuko Ohashi, Masayuki Ohashi, Naoto Endo, Tatsuro Kohno
BACKGROUND: We recently reported that tranexamic acid (TXA) evokes pain in rats by inhibiting γ-aminobutyric acid and glycine receptors on neurons in the spinal dorsal horn. Although TXA is commonly used to reduce perioperative blood loss during various surgeries, its potential to induce intraoperative nociception, thereby increasing the need for more analgesics during surgery, has not been investigated. Therefore, this study aimed to investigate whether TXA evokes pain and increases the need for a higher infusion rate of remifentanil in patients undergoing surgery for adolescent idiopathic scoliosis (AIS)...
2017: PloS One
https://www.readbyqxmd.com/read/28263046/seizures-associated-with-tranexamic-acid-for-cardiac-surgery-a-meta-analysis-of-randomized-and-non-randomized-studies
#5
Hisato Takagi, Tomo Ando, Takuya Umemoto
BACKGROUND: We focused whether tranexamic acid (TXA) therapy for adult cardiac surgery is associated with an increase in the risk of seizures and performed a meta-analysis of randomized controlled trials (RCTs) and non-randomized observational studies. METHODS: MEDLINE and EMBASE were searched through December 2016 using PubMed and OVID. Eligible studies were RCTs and non-randomized observational studies of TXA versus control (no TXA, placebo, or active control such as low-dose TXA, aprotinin, and epsilon aminocaproic acid) enrolling adult patients undergoing cardiac surgery and reporting the postoperative incidence of seizures as an outcome...
March 6, 2017: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/28262452/tranexamic-acid-was-safe-in-arthroplasty-patients-with-a-history-of-venous-thromboembolism-a-matched-outcome-study
#6
Orlando D Sabbag, Matthew P Abdel, Adam W Amundson, Dirk R Larson, Mark W Pagnano
BACKGROUND: In contemporary total hip arthroplasties (THAs) and total knee arthroplasties (TKAs), intravenous tranexamic acid (IV TXA) has proved efficacious in decreasing blood loss and transfusion. Interested in expanding the use of IV TXA to patients with a prior venous thromboembolic event (VTE), we sought out to determine the risk of recurrent VTE with TXA administration during primary THA and TKA. METHODS: We retrospectively reviewed 1262 patients (1620 cases) with a history of VTE who underwent primary THA or TKA between 2000 and 2012...
February 14, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28245519/pharmacokinetics-of-tranexamic-acid-in-neonates-and-infants-undergoing-cardiac-surgery
#7
Ralph Gertler, Michael Gruber, Stanislas Grassin-Delyle, Saïk Urien, Klaus Martin, Peter Tassani-Prell, Siegmund Braun, Simon Burg, Gunther Wiesner
AIM: Tranexamic acid (TXA) continues to be one of the antifibrinolytics of choice during paediatric cardiac surgery. However, in infants less than one year of age, the optimal dosing based on pharmacokinetic (PK) considerations is still under discussion. METHODS: 43 children less than one year of age were enrolled. 37 required the use of cardiopulmonary bypass (CPB) while 6 were operated on without CPB. 50 mg kg(-1) TXA i.v. at the induction of anaesthesia was followed by 50 mg kg(-1) into the CPB prime in the CPB group...
February 28, 2017: British Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28242029/tranexamic-acid-and-the-gut-barrier-protection-by-inhibition-of-trypsin-uptake-and-activation-of-downstream-intestinal-proteases
#8
Mark E Diebel, Lawrence N Diebel, David M Liberati
OBJECTIVE: Intraluminal pancreatic trypsin and other digestive enzymes injure the gut barrier following trauma-hemorrhagic shock (T/HS). Intestinal proteases (sheddases) exert important effects on normal gut function but may cause barrier disruption due to exaggerated production following T/HS. We hypothesized that the protective mechanism of TXA on the gut barrier following T/HS includes inhibition of these "downstream" proteases. This was studied in vitro. METHODS: Trypsin, matrix metalloproteinase (MMP-9) and ADAM-17 activity were measured in intestinal epithelial cells (IEC) exposed to HR + trypsin...
December 28, 2016: American Journal of Surgery
https://www.readbyqxmd.com/read/28238579/preoperative-coil-embolization-of-side-branches-and-postoperative-antifibrinolytic-therapy-in-endovascular-aneurysm-repair-a-propensity-score-analysis
#9
Arudo Hiraoka, Genta Chikazawa, Atsuhisa Ishida, Toshinori Totsugawa, Kentaro Tamura, Taichi Sakaguchi, Hidenori Yoshitaka
PURPOSE: To demonstrate feasibility and efficacy of preoperative coil embolization of side branches and postoperative tranexamic acid (TXA) therapy for management of type II endoleak and aneurysmal sac regression after endovascular aortic repair (EVAR). MATERIALS AND METHODS: This study included 284 patients who underwent EVAR between 2007 and 2014. In 133 patients (group A), since March 2012, preoperative coil embolization of side branches and postoperative TXA therapy had been introduced as a modified strategy after EVAR, including combined coil embolization and TXA therapy (n = 41), coil embolization only (n = 17), and TXA therapy only (n = 75)...
February 23, 2017: Journal of Vascular and Interventional Radiology: JVIR
https://www.readbyqxmd.com/read/28231650/blood-sparing-efficacy-of-oral-tranexamic-acid-in-primary-total-knee-arthroplasty-a-randomized-controlled-trial
#10
Qunn Jid Lee, Wai Yee Ching, Yiu Chung Wong
Purpose: Tranexamic acid (TXA) is effective in reducing blood loss in primary total knee replacement. Almost all studies used an intravenous form or a topical form. The aim of this study was to assess the blood sparing efficacy and the safety of oral TXA. Materials and Methods: All patients with primary total knee replacement performed in our institute from January 2015 to October 2015 were eligible. Oral TXA group was given 1 g oral TXA 2 hours before induction of anesthesia and 6 hours and 12 hours postoperatively...
March 1, 2017: Knee Surgery & related Research
https://www.readbyqxmd.com/read/28225743/damage-control-resuscitation-in-patients-with-severe-traumatic-hemorrhage-a-practice-management-guideline-from-the-eastern-association-for-the-surgery-of-trauma
#11
Jeremy W Cannon, Mansoor A Khan, Ali S Raja, Mitchell J Cohen, John J Como, Bryan A Cotton, Joseph J Dubose, Erin E Fox, Kenji Inaba, Carlos J Rodriguez, John B Holcomb, Juan C Duchesne
BACKGROUND: The resuscitation of severely injured bleeding patients has evolved into a multi-modal strategy termed damage control resuscitation (DCR). This guideline evaluates several aspects of DCR including the role of massive transfusion (MT) protocols, the optimal target ratio of plasma (PLAS) and platelets (PLT) to red blood cells (RBC) during DCR, and the role of recombinant activated factor VII (rVIIa) and tranexamic acid (TXA). METHODS: Using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology, a subcommittee of the Practice Management Guidelines (PMG) Section of EAST conducted a systematic review using MEDLINE and EMBASE...
March 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28222709/combined-application-versus-topical-and-intravenous-application-of-tranexamic-acid-following-primary-total-hip-arthroplasty-a-meta-analysis
#12
Pei Zhang, Yuan Liang, Pengtao Chen, Yongchao Fang, Jinshan He, Jingcheng Wang
BACKGROUND: The use of intravenous (IV) or topical tranexamic acid (TXA) in total hip arthroplasty has been proven to be effective and safe in total hip arthroplasty. However, which of these two administration routes is better has not been determined. The combined administration of TXA has been used in total knee arthroplasty with satisfactory results. We hypothesized that combined application of TXA may be the most effective way without increased rate of thrombotic events such as deep vein thrombosis (DVT) and pulmonary embolisms (PE) in patients subjected to primary total hip replacement (THA)...
February 21, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28221207/aprotinin-vs-tranexamic-acid-in-isolated-coronary-artery-bypass-surgery-a-large-multicentre-observational-study
#13
Elsa Deloge, Julien Amour, Sophie Provenchère, Bertrand Rozec, Bruno Scherrer, Alexandre Ouattara
BACKGROUND: Aprotinin appears to be more efficacious than lysine analogues to reduce bleeding and transfusion of blood products in high-transfusion-risk cardiac surgical patients. However, in isolated coronary artery bypass graft (CABG) surgery, the results from head-to-head trials remain less conclusive. OBJECTIVE: Our objective was to compare the efficacies and safety of aprotinin and tranexamic acid (TXA) in patients undergoing isolated on-pump CABG. DESIGN: A large multicentre before-and-after study pooling individual data from published trials and unpublished data from three other databases...
February 17, 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/28217656/use-of-tranexamic-acid-in-total-knee-arthroplasty
#14
Francesco Marra, Federica Rosso, Matteo Bruzzone, Davide Edoardo Bonasia, Federico Dettoni, Roberto Rossi
PURPOSE: different strategies have been developed to reduce blood loss in total knee arthroplasty (TKA). The efficacy of both systemic and local tranexamic acid (TXA) administration is demonstrated in the literature. The aim of the present study was to compare the efficacy of systemic, local and combined (systemic + local) administration of TXA in reducing blood loss after TKA. METHODS: we enrolled all patients submitted to a primary TKA in our department between November 2014 and August 2015...
October 2016: Joints
https://www.readbyqxmd.com/read/28208943/role-of-prophylactic-tranexamic-acid-in-reducing-blood-loss-during-elective-caesarean-section-a-randomized-controlled-study
#15
Sj Dhivya Lakshmi, Reena Abraham
INTRODUCTION: Obstetric haemorrhage accounts for 20-25% of maternal mortality and morbidity. Anti-fibrinolytics are being widely used in field of surgery. It is also used to reduce heavy menstrual blood loss. AIM: To analyse the effectiveness of Tranexamic Acid (TXA) in reducing blood loss during elective caesarean section. MATERIALS AND METHODS: This interventional, randomized, parallel group study was done in the Department of Obstetrics and Gynaecolgy, PSG IMSR, Coimbatore, from June 2014 to May 2015...
December 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28207503/clamping-drainage-is-unnecessary-after-minimally-invasive-total-knee-arthroplasty-in-patients-with-tranexamic-acid-a-randomized-controlled-trial
#16
RANDOMIZED CONTROLLED TRIAL
Yuangang Wu, Timin Yang, Yi Zeng, Canfeng Li, Bin Shen, Fuxing Pei
BACKGROUND: Drainage and tranexamic acid (TXA) have been widely used in total knee arthroplasty (TKA). However, it remains unclear whether it is necessary to clamp the drain after minimally invasive TKA (MIS-TKA) when TXA is used. We therefore conducted a randomized controlled trial to compare the effects of clamping versus not clamping drainage following MIS-TKA in patients in whom TXA was used. METHODS: From January 2015 to December 2015, 121 patients undergoing unilateral primary MIS-TKA were enrolled and randomly divided into 2 groups...
February 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28187013/the-effectiveness-and-safety-of-tranexamic-acid-in-orthotopic-liver-transplantation-clinical-practice-a-propensity-score-matched-cohort-study
#17
Adam Badenoch, Anand Sharma, Simon Gower, Markus Selzner, Coimbatore Srinivas, Marcin Wasowics, Stuart A McCluskey
BACKGROUND: Randomized trials have demonstrated the efficacy of Tranexamic acid (TXA) in reducing blood loss and transfusion requirements during liver transplantation. However, clinical utilization is limited due to a perceived lack of generalizable effectiveness and concerns regarding its thromboembolic risks. The aim of this study was to describe the clinical use of TXA and to provide a pragmatic re-appraisal of its effectiveness and safety. METHODS: Following ethics approval, data was collected from 1,799 consecutive liver transplant recipients between January 1st 2002 and December 31st 2015 using retrospectively collected electronic databases...
February 10, 2017: Transplantation
https://www.readbyqxmd.com/read/28184955/-tranexamic-acid-in-the-german-emergency-medical-service-a%C3%A2-national-survey
#18
V Zickenrott, I Greb, A Henkelmann, F Balzer, S Casu, L Kaufner, C von Heymann, K Zacharowski, C F Weber
BACKGROUND: Trauma-induced coagulopathy, one of the leading causes of trauma-related death, is detected in about one of four trauma patients upon hospital admission. The current European Management of Major Bleeding and Coagulopathy Following Trauma guidelines, published in 2013, recommend that tranexamic acid (TXA) be administered as early as possible to inhibit hyperfibrinolysis (grade of recommendation (GoR 1A)). Furthermore, it is suggested that protocols for the management of patients with bleeding or showing signs of bleeding include the administration of the first dose of TXA at the site of injury or during transportation to hospital (GoR 2C)...
February 9, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28176605/topical-versus-intravenous-tranexamic-acid-in-total-knee-arthroplasty
#19
Sanjay Meena, Francesco Benazzo, Saumitra Dwivedi, Matteo Ghiara
PURPOSE: The aim of this meta-analysis is to examine the efficacy and safety of intra-articular tranexamic acid (TXA) when compared to intravenous (IV) route. METHODS: The literature search was conducted using PubMed, Cochrane Library, MEDLINE, EMBASE and China National Knowledge Infrastructure (CNKI). All randomized controlled trials evaluating the effectiveness of topical route and IV route of TXA administration were included. RESULTS: Eight randomized clinical trials comprising of 857 patients were included in this analysis...
January 2017: Journal of Orthopaedic Surgery
https://www.readbyqxmd.com/read/28176599/the-combined-use-of-oral-and-topical-tranexamic-acid-is-a-safe-efficient-and-low-cost-method-in-reducing-blood-loss-and-transfusion-rates-in-total-knee-arthroplasty
#20
Deniz Cankaya, Uygar Dasar, Ahmet Burak Satilmis, Serdar Hakan Basaran, Mustafa Akkaya, Murat Bozkurt
AIMS: The combined (IV (intravenous) + topical) use of tranexamic acid (TXA) has been shown to be a safe method and more effective than single (IV or topical) application. The optimal administration method of TXA is still being investigated and safety, efficiency and cost are the three main crucial parameters in achieving the best administration method. We aimed to determine whether combined (oral + topical) use of TXA reduced blood loss and transfusion rates more than single (topical) administration in TKA and whether oral + topical use is as safe and efficient as the IV + topical use, in addition to the main advantage of relatively low cost...
January 2017: Journal of Orthopaedic Surgery
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