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https://www.readbyqxmd.com/read/28076488/use-of-tranexamic-acid-in-trauma-patients-an-analysis-of-cost-effectiveness-for-use-in-brazil
#1
Marcelo A Pinto, Jair G da Silva, Aljamir D Chedid, Marcio F Chedid
Introduction: Use of tranexamic acid (TXA) in trauma has been the subject of growing interest by researchers and health professionals. However, there are still several open questions regarding its use. In some aspects medical literature is controversial. The points of disagreement among experts include questions such as: Which patients should receive TXA in trauma? Should treatment be performed in the pre-hospital environment? Is there any need for laboratory parameters before starting TXA treatment? What is the drug safety profile? The main issue on which there is still no basis in literature is: What is the indication for treatment within massive transfusion protocols? Objective: Answer the questions proposed based on critical evaluation of the evidence gathered so far and carry out a study of cost-effectiveness of TXA use in trauma adapted to the Brazilian reality...
November 2016: Arquivos Brasileiros de Cirurgia Digestiva: ABCD, Brazilian Archives of Digestive Surgery
https://www.readbyqxmd.com/read/28061495/effectiveness-and-safety-of-tranexamic-acid-in-spinal-deformity-surgery
#2
Ho Yong Choi, Seung-Jae Hyun, Ki-Jeong Kim, Tae-Ahn Jahng, Hyun-Jib Kim
OBJECTIVE: Spinal deformity surgery has the potential risk of massive blood loss. To reduce surgical bleeding, the use of tranexamic acid (TXA) became popular in spinal surgery, recently. The purpose of this study was to determine the effectiveness of intra-operative TXA use to reduce surgical bleeding and transfusion requirements in spinal deformity surgery. METHODS: A total of 132 consecutive patients undergoing multi-level posterior spinal segmental instrumented fusion (≥5 levels) were analyzed retrospectively...
January 1, 2017: Journal of Korean Neurosurgical Society
https://www.readbyqxmd.com/read/28035773/additional-intraarticular-tranexamic-acid-further-reduced-postoperative-blood-loss-compared-to-intravenous-and-topical-bathed-tranexamic-acid-in-total-hip-arthroplasty-a-retrospective-sequential-series-study
#3
Nariaki Nakura, Kazuo Hirakawa, Satoshi Takayanagi, Akira Saito, Koji Tsuji, Yasunobu Tamaki, Shunsuke Ochiai, Masahiko Mihara
BACKGROUND: Topical tranexamic acid (TXA) administration has been described to be effective in decreasing blood loss in total hip arthroplasty (THA). The aim of this retrospective study was to evaluate whether topical intraarticular TXA administration in addition to intravenous (IV) and topical bathed TXA further reduces blood loss in THA patients. STUDY DESIGN AND METHODS: Four-hundred patients were enrolled in this sequential series study with two different phases during four different time periods...
December 30, 2016: Transfusion
https://www.readbyqxmd.com/read/28033139/air-medical-administration-of-tranexamic-acid
#4
Brian Cornelius
Traumatic injury is a significant cause of morbidity and mortality in the United States. Massive hemorrhage is responsible for the vast majority of deaths. Evolution in trauma treatment has resulted in major improvements to emergency care. Tranexamic acid (TXA), an antifibrinolytic agent, is synthetically derived from amino acids. The CRASH-2 study demonstrated that the early administration of TXA results in significant decreases in morbidity and mortality. Experiences by coalition forces in Southwest Asia found a substantial increase in survival of trauma patients with early TXA administration...
January 2017: Journal of Trauma Nursing: the Official Journal of the Society of Trauma Nurses
https://www.readbyqxmd.com/read/28031511/use-of-tranexamic-acid-in-dynamic-hip-screw-plate-fixation-for-trochanteric-fractures
#5
Ranjit Kumar Baruah, Pranab Jyoti Borah, Russel Haque
PURPOSE: To evaluate perioperative blood loss and blood transfusion requirement in patients who underwent dynamic hip screw plate fixation for a stable trochanteric fracture with or without preoperative intravenous tranexamic acid (TXA). METHODS: 49 men and 11 women (mean age, 56.5 years) who underwent open reduction and internal fixation with a dynamic hip screw plate for a stable trochanteric fracture by a single surgeon were equally randomised to receive either a single dose of intravenous TXA (15 mg/kg) 15 minutes prior to surgery or an equal volume of normal saline by slow infusion...
December 2016: Journal of Orthopaedic Surgery
https://www.readbyqxmd.com/read/28026726/-intra-articular-application-of-tranexamic-acid-significantly-reduces-blood-loss-and-transfusion-requirement-in-primary-total-knee-arthroplasty
#6
J Lošťák, J Gallo, J Špička, K Langová
PURPOSE OF THE STUDY The aim of this prospective study was to investigate the effect of topical application of tranexamic acid (TXA, Exacyl) on the amount of post-operative blood loss, and blood transfusion requirement in patients undergoing primary total knee arthroplasty (TKA). Attention was paid to early complications potentially associated with TXA administration, such as haematoma, wound exudate, or knee swelling. In addition, the economic benefit of TXA treatment was also taken into account. MATERIAL AND METHODS The study included 238 patients (85 men and 153 women) who underwent primary total knee arthroplasty (TKA) at our department between January 2013 and November 2015...
2016: Acta Chirurgiae Orthopaedicae et Traumatologiae Cechoslovaca
https://www.readbyqxmd.com/read/28005108/comparing-cost-efficacy-and-safety-of-intravenous-and-topical-tranexamic-acid-in-total-hip-and-knee-arthroplasty
#7
Joseph F DiBlasi, Ross P Smith, Jeffrey Garavaglia, Jeffrey Quedado, Benjamin M Frye, Matthew J Dietz
We conducted a study to compare the cost, efficacy, and safety of intravenous (IV) tranexamic acid (TXA) and topical TXA in primary total hip arthroplasty (THA) and total knee arthroplasty (TKA). We retrospectively reviewed the cases of 291 patients who received either IV TXA or topical TXA before and after surgery. Significant differences favored topical TXA in reducing the postoperative decrease in hemoglobin levels in THA (P = .031) and TKA (P = .015) and calculated blood loss in TKA (P = .019). The groups did not differ in transfusion requirements for either THA or TKA...
November 2016: American Journal of Orthopedics
https://www.readbyqxmd.com/read/28002321/is-combined-topical-with-intravenous-tranexamic-acid-superior-than-topical-intravenous-tranexamic-acid-alone-and-control-groups-for-blood-loss-controlling-after-total-knee-arthroplasty-a-meta-analysis
#8
Chunmei Lin, Yingmei Qi, Li Jie, Hong-Biao Li, Xi-Cheng Zhao, Lei Qin, Xin-Qiang Jiang, Zhen-Hua Zhang, Liping Ma
BACKGROUND: The purpose of this systematic review and meta-analysis of randomized controlled trials (RCTs) was to evaluate the efficacy and safety of combined topical with intravenous tranexamic acid (TXA) versus topical, intravenous TXA alone or control for reducing blood loss after a total knee arthroplasty (TKA). METHODS: In May 2016, a systematic computer-based search was conducted in the PubMed, Embase, Cochrane Library, Web of Science, and Chinese Wanfang database...
December 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27999500/benefits-of-limited-use-of-a-tourniquet-combined-with-intravenous-tranexamic-acid-during-total-knee-arthroplasty
#9
Alexander D Rosenstein, Yehuda A Michelov, Stephanie Thompson, Alan D Kaye
BACKGROUND: Blood loss during total knee arthroplasty (TKA) may require blood transfusions that are associated with increased risk, morbidity, and cost. Multiple techniques exist to reduce blood loss in TKA, including the use of a tourniquet and tranexamic acid (TXA). While multiple studies suggest that TXA is effective in reducing blood loss, the use of a tourniquet is more controversial. We studied the combined effect of TXA with a limited-use tourniquet on blood loss and complications in the setting of primary TKA...
2016: Ochsner Journal
https://www.readbyqxmd.com/read/27993197/tranexamic-acid-prolongs-survival-after-controlled-hemorrhage-in-rats
#10
Max Roy, Manuel Burggraf, Sven Lendemans, Herbert de Groot, Ricarda Rohrig
BACKGROUND: The plasmin/plasminogen inhibitor tranexamic acid (TXA) is mainly used in elective surgeries with a higher blood loss to avoid uncontrolled bleeding. Recently, TXA has also been shown to reduce mortality in trauma patients. It is assumed that its beneficial effects are principally caused by its antifibrinolytic properties. We hypothesize that TXA also improves survival in a modified Wigger's model of hemorrhagic shock by a mechanism other than antifibrinolysis. MATERIALS AND METHODS: Male Wistar rats were intermittently bled until the mean arterial blood pressure was dropped to 25-30 mm Hg (severe shock)...
February 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/27988092/safety-of-tranexamic-acid-in-pediatric-cardiac-surgery-a-nationwide-database-study
#11
Takuma Maeda, Yusuke Sasabuchi, Hiroki Matsui, Yoshihiko Ohnishi, Shigeki Miyata, Hideo Yasunaga
OBJECTIVES: The present study aimed to examine the association between tranexamic acid (TXA) use and adverse effects (seizures, thromboembolism, and renal dysfunction) in a pediatric cardiac surgery population using a national inpatient database in Japan. The authors also assessed the association between TXA use and other clinical outcomes (length of hospital stay and in-hospital mortality). DESIGN: A nationwide, retrospective cohort study using propensity score analyses...
October 4, 2016: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/27987219/relative-efficacy-of-tranexamic-acid-and-preoperative-anemia-treatment-for-reducing-transfusions-in-total-joint-arthroplasty
#12
Joseph F Styron, Alison K Klika, Caleb R Szubski, Deborah Tolich, Wael K Barsoum, Carlos A Higuera
BACKGROUND: This study aimed to evaluate the efficacy of a perioperative blood management (PBM) protocol at a large, tertiary hospital at reducing blood transfusions after total hip or knee arthroplasty (THA or TKA). STUDY DESIGN AND METHODS: A retrospective review of the PBM for patients undergoing THA or TKA was performed. Adjusted multiple logistic and Poisson regression models examined the effect of patient characteristics and preoperative, intraoperative, and postoperative factors on the likelihood of transfusion and units transfused...
December 17, 2016: Transfusion
https://www.readbyqxmd.com/read/27984847/intraarticular-administration-of-tranexamic-acid-is-safe-and-effective-in-total-knee-arthroplasty-patients-at-high-risk-for-thromboembolism
#13
Ronald E Delanois, Chukwuweike Gwam, Jaydev B Mistry, Morad Chughtai, Melbin Thomas, Prathik P Mudaliar, Anton Khlopas, Vidur Tangri, Michael A Mont
INTRODUCTION: Tranexamic acid (TXA) is an antifibrinolytic agent that can be used to reduce blood loss in total knee arthroplasty (TKA) patients. Due to its thrombogenic properties, intravenous (IV) TXA is contraindicated in patients who have an increased risk of arterial or venous thrombosis. For such patients, intraarticular (IA) TXA may be a safe alternative. In this study, we compare: 1) complication rates; 2) intraoperative blood loss; and 3) need for transfusion in TKA patients who received IA TXA versus patients who used IV TXA...
December 16, 2016: Surgical Technology International
https://www.readbyqxmd.com/read/27977593/comparing-efficacy-and-safety-of-2-methods-of-tranexamic-acid-administration-in-reducing-blood-loss-following-total-knee-arthroplasty-a-meta-analysis
#14
Yu Fu, Zhigang Shi, Bing Han, Yong Ye, Tao You, Juehua Jing, Jun Li
BACKGROUND: The purpose of this systematic review and meta-analysis of randomized controlled trials (RCTs) were to gather data to evaluate the efficacy and safety of topical tranexamic acid (TXA) versus intravenous (IV) TXA for blood loss after a total knee arthroplasty (TKA). METHODS: Electronic databases: Pubmed, Web of Science, Cochrane library, and Embase from inception to June 2016 were searched. RCTs that comparing topical with IV TXA for blood loss control in patients prepared for TKA were included in this meta-analysis...
December 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27977590/intravenous-versus-topical-tranexamic-acid-in-primary-total-hip-replacement-a-meta-analysis
#15
Pei Zhang, Yuan Liang, Pengtao Chen, Yongchao Fang, Jinshan He, Jingcheng Wang
BACKGROUND: As the prevalence of total hip arthroplasty (THA) is increasing, it is usually associated with considerable blood loss. Tranexamic acid (TXA) has been reported to reduce perioperative blood loss in hip joint arthroplasty. But the best route of TXA administration continues to be controversial. So, we conducted a meta-analysis that integrated all data from the 7 included trials to compare the effectiveness and safety of topical and intravenous TXA administration in primary THA...
December 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27913237/combined-use-of-intravenous-and-topical-versus-intravenous-tranexamic-acid-in-primary-total-joint-arthroplasty-a-meta-analysis-of-randomized-controlled-trials
#16
REVIEW
Xue-Qin Zhang, Jie Ni, Wei-Hong Ge
OBJECTIVE: To compare the safety and efficacy of combined use of intravenous and topical tranexamic acid with that of intravenous tranexamic acid in primary total joint arthroplasty. METHODS: Literature was searched in PubMed, Cochrane Library, Embase, Medline, and China National Knowledge Infrastructure databases. Only randomized controlled trials were included in our study. Data were using fixed-effects or random-effects models with standard mean differences and risk ratios for continuous and dichotomous variables, respectively...
November 30, 2016: International Journal of Surgery
https://www.readbyqxmd.com/read/27913130/topical-tranexamic-acid-is-equivalent-to-targeted-preoperative-autologous-blood-donation-in-total-hip-arthroplasty
#17
Maximilian F Kasparek, Martin Faschingbauer, Wenzel Waldstein, Cosima S Boettner, Friedrich Boettner
BACKGROUND: Topical tranexamic acid (TXA) was introduced to replace the previous targeted preoperative autologous blood donation (PABD) program. This study aims to analyze the efficacy of topical TXA compared with targeted PABD in anemic patients undergoing primary total hip arthroplasty (THA). METHODS: Two thousand two hundred fifty-one patients underwent primary THA between 2009 and 2013 using targeted autologous blood donation for 280 anemic patients (12%; Hb <12...
October 31, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/27907937/tranexamic-acid-for-trauma-resuscitation-in-the-united-states-of-america
#18
Mark Walsh, Scott Thomas, Ernest Moore, Hunter Moore, Andres Piscoya, Daniel Hake, Michael Son, Tim Pohlman, Julie Wegner, John Bryant, Alberto Grassetto, Patrick Davis, Nathan Nielsen, Anton Crepinsek, Jacob T Shreve, Francis Castellino
The utilization of tranexamic acid (TXA) for the management of bleeding trauma patients has been a subject of much debate on both sides of the Atlantic and in Australia. As a result of the large randomized controlled study called the Clinical Randomization of an Antifibrinolytic in Severe Hemorrhage (CRASH-2), there was an initial enthusiasm for the use of TXA to treat bleeding patients. However, the adoption of TXA in the United States was delayed by concerns of "knowledge and evidence gaps" of the CRASH-2 study and because of a lack of mechanistic rationale that would explain the survival benefit noted in the study...
December 1, 2016: Seminars in Thrombosis and Hemostasis
https://www.readbyqxmd.com/read/27900553/efficacy-and-safety-of-tranexamic-acid-in-reducing-blood-loss-in-scoliosis-surgery-a-systematic-review-and-meta-analysis
#19
REVIEW
Qiu-Ming Yuan, Zhi-Hu Zhao, Bao-Shan Xu
OBJECTIVE: The purpose of this systematic review and meta-analysis of randomized controlled trials (RCTs) and non-RCTs was to gather data to evaluate the efficacy and safety of tranexamic acid (TXA) versus placebo after a scoliosis surgery. METHODS: The electronic databases including Embase, PubMed, CENTRAL (Cochrane Controlled Trials Register), Web of Science, and Google database were searched to identify relevant studies published from the time of the establishment of these databases up to May 2016...
November 29, 2016: European Spine Journal
https://www.readbyqxmd.com/read/27895370/lower-red-cell-transfusion-rates-with-use-of-tranexamic-acid-in-single-stage-bilateral-total-knee-arthroplasty-a-retrospective-audit
#20
Muhammad Aziz, Salman Bin Mahmood, Riaz Hussain Lakdawala, Tashfeen Ahmad
Bilateral total knee arthroplasty (BTKA) patients may require blood transfusion which has its risks. Anti-fibrinolytic drugs such as aprotinin, aminocaproic acid and tranexamic acid (TXA) have reduced transfusion requirements in major surgery. This retrospective audit was performed to assess effectiveness of TXA in reducing blood transfusion rate in single-stage sequential BTKA cases operated by a single surgeon. Records of 91 patients given TXA and 80 controls who were operated before 2012 and not given TXA were reviewed...
October 2016: JPMA. the Journal of the Pakistan Medical Association
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