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https://www.readbyqxmd.com/read/28939033/epsilon-aminocaproic-acid-to-reduce-blood-loss-and-transfusion-after-total-hip-and-total-knee-arthroplasty
#1
Juliann C Hobbs, Ian J Welsby, Cynthia L Green, Ishwori B Dhakal, Samuel S Wellman
BACKGROUND: Total hip and knee arthroplasty (THA and TKA) are associated with significant blood loss and some patients require postoperative blood transfusion. While tranexamic acid has been studied extensively among this population, we tested the hypothesis that epsilon aminocaproic acid (EACA) can reduce blood loss and transfusion after joint arthroplasty. METHODS: In April 2014, our Veterans Affairs Medical Center introduced a protocol to administer EACA during THA and TKA...
August 24, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28938283/effect-of-tranexamic-acid-on-transfusion-a-randomized-clinical-trial-in-acetabular-fracture-surgery
#2
William D Lack, Brett D Crist, Rachel B Seymour, William Harvin, Madhav A Karunakar
OBJECTIVES: Given the increasing evidence that minimizing blood loss and limiting allogeneic transfusion can improve patient outcome, we are performing a randomized controlled trial of the use of tranexamic acid (TXA) during acetabular fracture surgery. DESIGN: Prospective, multicenter, and randomized. SETTING: Two level I trauma centers. PARTICIPANTS: Eighty-eight patients underwent randomization, with 42 assigned to the TXA group and 46 assigned to the placebo group...
October 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28938282/efficacy-and-safety-of-tranexamic-acid-in-orthopaedic-fracture-surgery-a-meta-analysis-and-systematic-literature-review
#3
Kamil M Amer, Saqib Rehman, Kamal Amer, Christopher Haydel
BACKGROUND: Tranexamic acid (TXA) is an antifibrinolytic drug that has been shown to be effective in reducing blood loss and the need for transfusions after several orthopaedic surgeries. However, the effectiveness of TXA use in orthopaedic fracture surgeries still remains unclear. The purpose of this meta-analysis was to review existing literature with interest in the effectiveness and safety of TXA treatment in reducing total blood loss and transfusion rates for patients who underwent surgery for fracture repairs...
October 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28938281/tranexamic-acid-in-orthopaedic-trauma-surgery-a-meta-analysis
#4
Elizabeth B Gausden, Rameez Qudsi, Myles D Boone, Brian OʼGara, Joseph J Ruzbarsky, Dean G Lorich
AIM: To systematically review and quantify the efficacy of tranexamic acid (TXA) use in reducing the risk of receiving a blood transfusion in patients undergoing orthopaedic trauma surgery, in reducing blood loss, and risk of thromboembolic events. METHODS: A systematic literature search was performed using MEDLINE, Embase, ClinicalTrials.gov, and conference proceeding abstracts from 2014 to 2016. A minimum of 2 reviewers screened each study and graded quality. The primary outcome measure was the risk of receiving a blood transfusion in the TXA group versus control...
October 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28933328/-local-application-of-tranexamic-acid-in-total-hip-arthroplasty-decreases-blood-loss-and-consumption-of-blood-transfusion
#5
J Lošťák, J Gallo, M Večeřa, J Špička, K Langová
PURPOSE OF THE STUDY The primary aim of our study was to identify the effects of local application of tranexamic acid (TXA, Exacyl) on the amount of postoperative blood loss and blood transfusion requirement in primary total hip arthroplasty. We also recorded the levels of postoperative haemoglobin and its drop in early period after surgery. In each patient, we monitored in detail the incidence of early complications (haematoma, wound exudate). Lastly, the economic aspect of TXA administration was also taken into account...
2017: Acta Chirurgiae Orthopaedicae et Traumatologiae Cechoslovaca
https://www.readbyqxmd.com/read/28930952/military-use-of-tranexamic-acid-in-combat-trauma-does-it-matter
#6
Jeffrey T Howard, Zsolt T Stockinger, Andrew P Cap, Jeffrey A Bailey, Kirby R Gross
BACKGROUND: Tranexamic acid (TXA) has been previously reported to have a mortality benefit in civilian and combat-related trauma, and was thus added to the Joint Theater Trauma System Damage Control Resuscitation Clinical Practice Guideline. As part of ongoing system-wide performance improvement, the use of TXA has been closely monitored. The goal was to evaluate the efficacy and safety of TXA use in military casualties and provide additional guidance for continued use. METHODS: A total of 3,773 casualties were included in this retrospective, observational study of data gathered from a trauma registry...
October 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28927562/periarticular-injection-of-tranexamic-acid-reduces-blood-loss-and-the-necessity-for-allogeneic-transfusion-after-total-knee-arthroplasty-using-autologous-transfusion-a-retrospective-observational-study
#7
Sain Yozawa, Hiroyasu Ogawa, Kazu Matsumoto, Haruhiko Akiyama
BACKGROUND: This study aimed to examine the influence of a periarticular injection of tranexamic acid (TXA) on blood loss after a total knee arthroplasty (TKA) in patients who received an autologous blood transfusion. METHODS: We retrospectively reviewed the medical charts of 82 patients (88 consecutive knees) who underwent a primary unilateral TKA with or without a periarticular TXA injection (TXA and control groups, respectively). All patients underwent an autologous blood transfusion...
August 24, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28914172/effects-of-pharmacological-inhibition-of-plasminogen-binding-on-liver-regeneration-in-rats
#8
Atsushi Miura, Kyoko Ishiguro, Kouta Koizumi, Yuki Yaita, Yori Ozaki-Masuzawa, Takashi Hosono, Taiichiro Seki
The fibrinolysis system is thought to play an important role in liver regeneration. We previously found that plasminogen (Plg) is localized to the cell surface of regenerating liver tissue as well as proliferating hepatocytes in vitro. Here, we investigated the significance of Plg binding to the cell surface during liver regeneration. Pre-administration of tranexamic acid (TXA), which is a competitive inhibitor of Plg binding, to hepatectomized rats mildly delayed restoration of liver weight in vivo. Although binding of Plg to the cell membrane decreased following TXA administration, TXA showed little effect on hepatocyte proliferation in rats...
September 15, 2017: Bioscience, Biotechnology, and Biochemistry
https://www.readbyqxmd.com/read/28912909/the-use-of-tranexamic-acid-for-upper-gastrointestinal-bleeding-by-medical-and-surgical-intensivists-a-single-center-experience
#9
Jason Chertoff, Grant Lowther, Hassan Alnuaimat, Ali Ataya
BACKGROUND: Tranexamic acid (TXA) may be beneficial in the management of upper gastrointestinal bleeding (UGIB). We sought to investigate how frequently intensivists at our academic institution use TXA for patients with UGIB, and to investigate whether the utilization rate of TXA differs between surgical and medical intensivists, and provide an updated literature review on the subject. METHODS: We performed a retrospective cohort study of patients admitted for UGIB to the surgical intensive care unit (SICU) and the medical intensive care unit (MICU) at our academic healthcare facility (University of Florida Health - Shands Hospital) from January 1, 2013 to December 31, 2016...
August 2017: Gastroenterology Research
https://www.readbyqxmd.com/read/28910469/prehospital-administration-of-tranexamic-acid-by-ground-forces-in-afghanistan-the-prehospital-trauma-registry-experience
#10
Steven G Schauer, Michael D April, Jason F Naylor, Jonathan Wiese, Kathy L Ryan, Andrew D Fisher, Cord W Cunningham, Noah Mitchell, Mark A Antonacci
BACKGROUND: Tranexamic acid (TXA) was shown to reduce overall mortality and death secondary to hemorrhage in a large prospective study. This intervention is time sensitive. As such, the Tactical Combat Casualty Care (TCCC) guidelines recommend use of this low-cost, safe intervention among patients with possible hemorrhagic shock, penetrating trauma to the thorax or trunk, or extremity amputation. OBJECTIVE: Prehospital administration of TXA by ground forces in the Afghanistan combat theater is described...
2017: Journal of Special Operations Medicine: a Peer Reviewed Journal for SOF Medical Professionals
https://www.readbyqxmd.com/read/28906369/the-efficacy-of-tranexamic-acid-in-reducing-blood-loss-in-total-shoulder-arthroplasty-a-meta-analysis
#11
Jing He, Xi-E Wang, Guo-Hong Yuan, Lian-Hai Zhang
BACKGROUND: The purpose of this meta-analysis is to compare the efficacy of tranexamic acid (TXA) versus placebo after a total shoulder arthroplasty (TSA). METHODS: In April 2017, a systematic computer-based search was conducted in the databases of PubMed, Embase, Web of Science, Cochrane Library, and Google. Studies comparing TXA versus placebo in reducing blood loss after TSA were included. The endpoints were the need for transfusion, blood loss in drainage, hemoglobin drop, and total blood loss...
September 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28902659/tranexamic-acid-in-shoulder-arthroplasty-a-systematic-review-and-meta-analysis
#12
Jacob M Kirsch, Asheesh Bedi, Nolan Horner, J Michael Wiater, Leo Pauzenberger, Denise M Koueiter, Bruce S Miller, Mohit Bhandari, Moin Khan
BACKGROUND: The role of tranexamic acid (TXA) in reducing blood loss following primary shoulder arthroplasty has been demonstrated in small retrospective and controlled clinical trials. This study comprehensively evaluates current literature on the efficacy of TXA to reduce perioperative blood loss and transfusion requirements following shoulder arthroplasty. METHODS: PubMed, MEDLINE, CENTRAL, and Embase were searched from the database inception date through October 27, 2016, for all articles evaluating TXA in shoulder arthroplasty...
September 12, 2017: JBJS Reviews
https://www.readbyqxmd.com/read/28887640/clinical-and-instrumental-evaluation-of-two-different-regimens-of-tranexamic-acid-in-total-hip-arthroplasty-a-single-centre-prospective-randomized-study-with-80-patients
#13
Nicola Piolanti, Andrea Del Chiaro, Fabrizio Matassi, Angelo Graceffa, Lorenzo Nistri, Massimiliani Marcucci
PURPOSE: The use of tranexamic acid (TXA) in total hip arthroplasty (THA) can significantly reduce blood losses with many clinical and economical advantages. However, no consensus has been reached regarding the optimal regimen for TXA administration. The aim of this study is to analyse and compare the haemostatic effect of two different intravenous (IV) regimens of TXA. MATERIALS AND METHODS: We planned a single-centre, prospective, randomized study including 80 patients who underwent primary unilateral minimally invasive THA because of a hip osteoarthritic degeneration...
September 8, 2017: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/28885402/tranexamic-acid-for-the-management-of-obstetric-hemorrhage
#14
Luis D Pacheco, Gary D V Hankins, Antonio F Saad, Maged M Costantine, Giuseppe Chiossi, George R Saade
Obstetric hemorrhage remains the most common cause of maternal mortality worldwide. It is believed that increased fibrinolytic activity, secondary to release and activation of endothelial tissue plasminogen activator, is involved in its pathogenesis. Tranexamic acid (TXA), an antifibrinolytic agent, has been shown to be beneficial in trauma patients if used within 3 hours of injury. A recent large randomized controlled trial showed that TXA given to hemorrhaging women within 3 hours after delivery was associated with decreased risk of death resulting from bleeding with no increase in thromboembolic complications...
October 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28858904/tranexamic-acid-administration-during-on-pump-cardiac-surgery-a-survey-of-current-practices-among-canadian-anesthetists-working-in-academic-centers
#15
Jessica Spence, Steven Long, Antonella Tidy, Karen Raymer, P J Devereaux, Andre Lamy, Richard Whitlock, Summer Syed
BACKGROUND: Tranexamic acid (TXA) is commonly administered during on-pump cardiac surgery to minimize bleeding. However, an optimal dosing regimen has not been described, and recent studies suggest that higher doses may be associated with seizure. Little is known about current practice among cardiac anesthetists. METHODS: We contacted all academic anesthesia departments in Canada to identify cardiac anesthetists, who represent the majority of practitioners. This group constituted our sampling frame...
August 30, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28857806/reversing-dabigatran-anticoagulation-with-prothrombin-complex-concentrate-versus-idarucizumab-as-part-of-multimodal-hemostatic-intervention-in-an-animal-model-of-polytrauma
#16
Markus Honickel, Till Braunschweig, Rolf Rossaint, Christian Stoppe, Hugo Ten Cate, Oliver Grottke
BACKGROUND: Although idarucizumab is the preferred treatment for urgent dabigatran reversal, it is not always available. Prothrombin complex concentrate (PCC) may be an alternative and, with bleeding in trauma, additional hemostatic therapy may be required. The authors investigated multimodal treatment in a preclinical polytrauma model. METHODS: Dabigatran etexilate (30 mg/kg twice daily) was given orally to 45 male pigs for 3 days. On day 4, animals received a dabigatran infusion before blunt liver injury and bilateral femur fractures...
August 30, 2017: Anesthesiology
https://www.readbyqxmd.com/read/28851694/dose-optimisation-of-intravenous-tranexamic-acid-for-elective-hip-and-knee-arthroplasty-the-effectiveness-of-a-single-pre-operative-dose
#17
R J M Morrison, B Tsang, W Fishley, I Harper, J C Joseph, M R Reed
OBJECTIVES: We have increased the dose of tranexamic acid (TXA) in our enhanced total joint recovery protocol at our institution from 15 mg/kg to 30 mg/kg (maximum 2.5 g) as a single, intravenous (IV) dose. We report the clinical effect of this dosage change. METHODS: We retrospectively compared two cohorts of consecutive patients undergoing total hip arthroplasty (THA) or total knee arthroplasty (TKA) surgery in our unit between 2008 and 2013. One group received IV TXA 15 mg/kg, maximum 1...
August 2017: Bone & Joint Research
https://www.readbyqxmd.com/read/28826906/aluminum-exposure-at-human-dietary-levels-promotes-vascular-dysfunction-and-increases-blood-pressure-in-rats-a-concerted-action-of-nad-p-h-oxidase-and-cox-2
#18
Caroline Silveira Martinez, Janaina Trindade Piagette, Alyne Gourlart Escobar, Ángela Martín, Roberto Palacios, Franck Maciel Peçanha, Dalton Valentim Vassallo, Christopher Exley, María Jesús Alonso, Marta Miguel, Mercedes Salaices, Giulia Alessandra Wiggers
Aluminum (Al) is a non-essential metal and a significant environmental contaminant and is associated with a number of human diseases including cardiovascular disease. We investigated the effects of Al exposure at doses similar to human dietary levels on the cardiovascular system over a 60day period. Wistar male rats were divided into two major groups and received orally: 1) Low aluminum level - rats were subdivided and treated for 60days as follows: a) Untreated - ultrapure water; b) AlCl3 at a dose of 8.3mg/kg bw for 60days, representing human Al exposure by diet; and 2) High aluminum level - rats were subdivided and treated for 42days as follows: C) Untreated - ultrapure water; d) AlCl3 at 100mg/kg bw for 42days, representing a high level of human exposure to Al...
August 19, 2017: Toxicology
https://www.readbyqxmd.com/read/28819631/effect-of-tranexamic-acid-on-hematologic-values-and-blood-loss-in-reverse-total-shoulder-arthroplasty
#19
Sae Hoon Kim, Whan Ik Jung, Young Jun Kim, Do Hyeon Hwang, Young Eun Choi
PURPOSE: Use of tranexamic acid (TXA) in the setting of arthroplasty of the lower extremity has been previously described. The aim of this study was to evaluate the benefit of a single dose of TXA (500 mg vial) administered intravenously just prior to RTSA in an Asian population. METHODS: The records of 48 patients (no TXA, n = 24, versus TXA, n = 24) that underwent RTSA for cuff tear arthropathy were retrospectively reviewed. All patients had a Hemovac drain positioned for 2 days after surgery...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28816954/tranexamic-acid-decreases-blood-loss-in-shoulder-arthroplasty-a-meta-analysis
#20
Bin-Feng Yu, Guo-Jing Yang, Qi Li, Liang-le Liu
BACKGROUND: The objective of this meta-analysis was to evaluate the efficacy and safety of tranexamic acid (TXA) in shoulder arthroplasty (SA). METHODS: Academic articles were identified from the Cochrane Library, Medline (1966-2017.2), PubMed (1966-2017.2), Embase (1980-2017.2), and ScienceDirect (1966-2017.2). Randomized controlled trials (RCTs) and non-RCTs studying TXA in SA were included. Two independent reviewers conducted independent data abstraction. The I statistic was used to assess heterogeneity...
August 2017: Medicine (Baltimore)
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