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https://www.readbyqxmd.com/read/29343449/the-comparative-efficacy-and-safety-of-topical-and-intravenous-tranexamic-acid-for-reducing-perioperative-blood-loss-in-total-knee-arthroplasty-a-randomized-controlled-non-inferiority-trial
#1
Jefferson George, Krishna Kiran Eachempati, Koushik Narayan Subramanyam, A V Gurava Reddy
BACKGROUND: Total Knee Arthroplasty (TKA) can be associated with significant perioperative blood loss and blood transfusions. This is a prospective randomised non-inferiority trial comparing intraarticular (IA) and intravenous (IV) routes of administering Tranexamic acid (TXA) with regard to efficacy and safety. METHODS: A total of 113 patients who underwent primary unilateral TKA from January to June 2017 randomly received either 1.5g TXA in 100mL normal saline solution (IA group, n=58) or 10mg/kg TXA (IV group, n=55) at 10min before the tourniquet inflation and at tourniquet release...
January 14, 2018: Knee
https://www.readbyqxmd.com/read/29339919/effect-of-oral-tranexamic-acid-on-macular-edema-associated-with-retinal-vein-occlusion-or-diabetes
#2
Masayuki Takeyama, Fumio Takeuchi, Masahiko Gosho, Keijiro Sugita, Masahiro Zako, Masayoshi Iwaki, Motohiro Kamei
Purpose: Tranexamic acid (TXA) is a widely used antifibrinolytic agent that can also cause a decrease in vascular permeability. We hypothesized that TXA could improve macular edema (ME) that is caused by an increase in retinal vascular permeability. The aim of this study is to evaluate the efficacy of oral TXA for ME associated with retinal vein occlusion (RVO) or diabetic ME (DME). Patients and methods: Oral TXA (1,500 mg daily for 2 weeks) was administered to patients with persistent ME secondary to RVO (7 eyes) and DME (7 eyes)...
2018: Clinical Ophthalmology
https://www.readbyqxmd.com/read/29318575/post-partum-haemorrhage-and-tranexamic-acid-a-global-issue
#3
REVIEW
Stephen P Hibbs, Ian Roberts, Haleema Shakur-Still, Beverley J Hunt
Post-partum haemorrhage (PPH) remains the major cause of maternal death worldwide, with the overwhelming majority of bleeding deaths occurring in low income countries. These bleeding deaths occur due to a complex network of biological and socioeconomic factors, including changes to haemostasis and fibrinolysis during pregnancy. Tranexamic acid (TxA) has been shown to reduce death in bleeding trauma patients safely and is effective in reducing bleeding in surgical patients, however its role in PPH has been less well established...
January 9, 2018: British Journal of Haematology
https://www.readbyqxmd.com/read/29309319/tranexamic-acid-dosing-for-cardiac-surgical-patients-with-chronic-renal-dysfunction-a-new-dosing-regimen
#4
Angela Jerath, Qi Joy Yang, K Sandy Pang, Nikita Looby, Nathaly Reyes-Garces, Tijana Vasiljevic, Barbara Bojko, Janusz Pawliszyn, Duminda Wijeysundera, W Scott Beattie, Terrence M Yau, Marcin Wąsowicz
BACKGROUND: Tranexamic acid (TXA) is a common antifibrinolytic agent used to minimize bleeding in cardiac surgery. Up to 50% cardiac surgical patients have chronic renal dysfunction (CRD). Optimal dosing of TXA in CRD remains poorly investigated. This is important as TXA is renally eliminated with accumulation in CRD. High TXA doses are associated with postoperative seizures. This study measures plasma TXA concentrations in CRD cardiac surgical patients for pharmacokinetic modeling and dose adjustment recommendations...
January 5, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29303065/clinical-research-of-combined-intravenous-administration-and-topical-application-of-tranexamic-acid-to-a-surgical-wound-during-posterior-lumbar-fusion
#5
Yufu Ou, Jianxun Wei, Rongzhu Li, Bin Liang, Dezan Qiu, Minke Wei, Xiaoping Mu, Zhuhai Li
BACKGROUND: The safety and effectiveness of combined intravenous and topical administration of tranexamic acid (TXA) on the reduction of blood loss in patients undergoing posterior lumbar fusion are not yet clear. The study aimed to investigate the safety and effectiveness of the combined intravenous and topical administration of TXA on the reduction of blood loss in patients undergoing posterior lumbar fusion. METHOD: One hundred and eighteen patients who underwent double-segment posterior lumbar decompression and fusion from February 2014 to May 2016 in our hospital were retrospectively reviewed...
January 1, 2018: Surgical Innovation
https://www.readbyqxmd.com/read/29298240/increased-risk-of-fibrinolysis-shutdown-among-severely-injured-trauma-patients-receiving-tranexamic-acid
#6
Jonathan P Meizoso, Roman Dudaryk, Michelle B Mulder, Juliet J Ray, Charles A Karcutskie, Sarah A Eidelson, Nicholas Namias, Carl I Schulman, Kenneth G Proctor
BACKGROUND: The association between tranexamic acid (TXA) and fibrinolysis shutdown is unknown. We hypothesize that TXA is associated with fibrinolysis shutdown in critically injured trauma patients. METHODS: 218 critically injured adults admitted to the intensive care unit (ICU) at an urban level 1 trauma center from 08/2011-01/2015 who had thromboelastography performed upon ICU admission were reviewed. Groups were stratified based on fibrinolysis shutdown, which was defined as LY30<0...
January 2, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29296720/x-ray-crystal-structure-of-plasmin-with-tranexamic-acid-derived-active-site-inhibitors
#7
Ruby H P Law, Guojie Wu, Eleanor W W Leung, Koushi Hidaka, Adam J Quek, Tom T Caradoc-Davies, Devadharshini Jeevarajah, Paul J Conroy, Nigel M Kirby, Raymond S Norton, Yuko Tsuda, James C Whisstock
The zymogen protease plasminogen and its active form plasmin perform key roles in blood clot dissolution, tissue remodeling, cell migration, and bacterial pathogenesis. Dysregulation of the plasminogen/plasmin system results in life-threatening hemorrhagic disorders or thrombotic vascular occlusion. Accordingly, inhibitors of this system are clinically important. Currently, tranexamic acid (TXA), a molecule that prevents plasminogen activation through blocking recruitment to target substrates, is the most widely used inhibitor for the plasminogen/plasmin system in therapeutics...
May 9, 2017: Blood Advances
https://www.readbyqxmd.com/read/29283963/clinical-relevance-of-a-p-value-does-txa-save-lives-after-trauma-or-post-partum-hemorrhage
#8
Geoffrey P Dobson, Kenji Doma, Hayley L Letson
No abstract text is available yet for this article.
December 28, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29249226/tranexamic-acid-prophylaxis-in-hip-and-knee-joint-replacement
#9
Matthias Goldstein, Carsten Feldmann, Hinnerk Wulf, Thomas Wiesmann
BACKGROUND: The antifibrinolytic agent tranexamic acid (TXA) is widely used for the prevention and treatment of hyperfibrinolytic states, such as in severe polytrauma. It can also be used for the systemic prevention of hemorrhage in elective orthopedic procedures. In this review, we assess the efficacy and risks of the prophylactic administration of tranexamic acid before major endoprosthetic surgery of the hip and knee. METHODS: This review is based on pertinent articles retrieved by a selective literature search in the PubMed and Cochrane Library databases...
December 1, 2017: Deutsches Ärzteblatt International
https://www.readbyqxmd.com/read/29246849/can-tranexamic-acid-conserve-blood-and-save-operative-time-in-spinal-surgeries-a-meta-analysis
#10
Shangyi Hui, Derong Xu, Zhinan Ren, Xin Chen, Lin Sheng, Qianyu Zhuang, Shugang Li
BACKGROUND CONTEXT: It is widely accepted that tranexamic acid (TXA) effectively reduces blood losses and transfusions in major surgeries. However, limited studies investigated the role of TXA in conserving blood and saving operative time in spine surgeries. Purpose This meta-analysis was conducted to gather scientific evidences for TXA efficacy on conserving blood and saving operative time in spine surgeries. STUDY DESIGN: A meta analysis. Patient Sample Eighteen RCTs and 18 non-RCT studies involving 2,572 patients were included in the final analyses, comparing the effectiveness of intravenous TXA with a placebo/no treatment group...
December 12, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/29239953/the-impact-of-prehospital-tranexamic-acid-on-blood-coagulation-in-trauma-patients
#11
Philipp Stein, Jan-Dirk Studt, Roland Albrecht, Stefan Müller, Dieter von Ow, Simon Fischer, Burkhardt Seifert, Sergio Mariotti, Donat R Spahn, Oliver M Theusinger
BACKGROUND: There is limited data on prehospital administration of tranexamic acid (TXA) in civilian trauma. The aim of this study was to evaluate changes in coagulation after severe trauma from on-scene to the hospital after TXA application in comparison to a previous study without TXA. METHODS: The study protocol was registered at ClinicalTrials.gov (NCT02354885). A prospective, multicenter, observational study investigating coagulation status in 70 trauma patients receiving TXA (1 g intravenously) on-scene versus a control group of 38 patients previously published without TXA...
December 11, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29232926/differential-effects-of-seh-inhibitors-on-the-proliferation-and-migration-of-vascular-smooth-muscle-cells
#12
Hyo Seon Kim, Sang Kyum Kim, Keon Wook Kang
Epoxyeicosatrienoic acid (EET) is a cardioprotective metabolite of arachidonic acid. It is known that soluble epoxide hydrolase (sEH) is involved in the metabolic degradation of EET. The abnormal proliferation and migration of vascular smooth muscle cells (VSMCs) play important roles in the pathogenesis of atherosclerosis and restenosis. Thus, the present study investigated the effects of the sEH inhibitor 12-(((tricyclo(3.3.1.13,7)dec-1-ylamino)carbonyl)amino)-dodecanoic acid (AUDA) on platelet-derived growth factor (PDGF)-induced proliferation and migration in rat VSMCs...
December 11, 2017: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/29232560/the-effect-of-tranexamic-acid-and-gender-on-intraoperative-bleeding-in-orthognathic-surgery-a-randomized-controlled-trial
#13
Jesper Jared Secher, Johannes Jakobsen Sidelmann, Janne Ingerlsev, Jens Jørgen Thorn, Else Marie Pinholt
PURPOSE: The purpose of this randomized trial was to measure the effect of intravenously administered tranexamic acid (TXA) on intraoperative blood loss (IOB) in patients undergoing bimaxillary orthognathic surgery (OS). MATERIALS AND METHODS: The authors designed and implemented a double-blinded placebo-controlled trial composed of patients eligible for OS at the Hospital of South West Denmark (Esbjerg, Denmark) from August 2014 through September 2016. The primary predictor variable was a single intravenous dose of TXA 1 g administered preoperatively or an equivalent saline placebo...
November 21, 2017: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/29221841/risk-factors-for-reaching-the-post-operative-transfusion-trigger-in-a-community-primary-total-knee-arthroplasty-population
#14
Stefano A Bini, Jeanne A Darbinian, William T Brox, Monti Khatod
BACKGROUND: Little data exist to evaluate an individual's pre-operative risk of blood transfusion following total knee arthroplasty (TKA). Our aim is to identify the risk factors associated with reaching the transfusion trigger of Hb <8 g/dL (TT8) following surgery and how perioperative tranexamic acid (TXA) affects that outcome. METHODS: Using a retrospective cohort study design, routine, unilateral TKAs performed between 2011 and 2013 in 19 hospitals were reviewed...
December 5, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29201870/factors-that-influence-blood-loss-and-need-for-transfusion-following-total-knee-arthroplasty
#15
Achilleas Boutsiadis, Ryan Jacob Reynolds, Mo Saffarini, Jean-Claude Panisset
Background: Blood loss during total knee arthroplasty (TKA) remains a concern, as many patients require blood transfusions, which increase risks of allergic reactions, disease transmission, and thromboembolisms. The purpose was to determine factors associated with blood loss and need for transfusion in patients receiving routine TKA. Methods: The authors prospectively analyzed 150 consecutive uncemented TKAs for age, gender, body mass index (BMI), anticoagulant medication, type of anesthesia, tranexamic acid (TXA) administration, tourniquet inflation, drain placement, pre- and post-operative Haemoglobin (Hb) level (g/dL), and whether transfusion was necessary...
November 2017: Annals of Translational Medicine
https://www.readbyqxmd.com/read/29194320/no-iv-no-problem-intraosseous-administration-of-tranexamic-acid-is-as-effective-as-intravenous-in-a-porcine-hemorrhage-model
#16
Michael S Lallemand, Donald M Moe, John M McClellan, Michael Loughren, Shannon Marko, Matthew J Eckert, Matthew J Martin
BACKGROUND: The acute coagulopathy of trauma is often accompanied by hyperfibrinolysis. TXA can reverse this phenomenon, and, when given early, decreases mortality from bleeding. Establishing IV access can be difficult in trauma and IO access is often preferred for drug administration. Currently, there is no data on the efficacy of IO administered TXA. Our objectives were to compare serum concentrations of tranexamic acid (TXA) when given IV and intraosseous (IO) and to compare the efficacy of IO administered TXA to IV at reversing hyperfibrinolysis METHODS: Using a porcine hemorrhage and ischemia-reperfusion (IR) model, 18 swine underwent hemorrhagic shock followed by a tissue plasminogen activator (tPA) infusion to induce hyperfibrinolysis...
December 1, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29194278/craniosynostosis-surgery-and-the-impact-of-tranexamic-acid-dosing
#17
Nicole M Kurnik, Lacey R Pflibsen, Annie Do, Ruth Bristol, Davinder J Singh
Consensus does not exist regarding the best dosage regimen for using tranexamic acid (TXA) for patients undergoing open calvarial vault remodeling in craniosynostosis surgery. The purpose of this study was to evaluate 2 dosing protocols, as well as the cost of using TXA. Previously, the institutional protocol was to give patients undergoing open calvarial vault remodeling a loading infusion of TXA (10 mg/kg) at the start of their procedure, after which intravenous TXA (5 mg/kg/h) was given throughout surgery and for 24 hours postoperatively...
November 20, 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/29193211/is-tranexamic-acid-exposure-related-to-blood-loss-in-hip-arthroplasty-a-pharmacokinetic-pharmacodynamic-study
#18
Julien Lanoiselée, Paul J Zufferey, Edouard Ollier, Sophie Hodin, Xavier Delavenne
AIMS: Tranexamic acid (TXA) is an antifibrinolytic agent, decreasing blood loss in hip arthroplasty. The present study investigated the relationship between TXA exposure markers, including the time above the in vitro threshold reported for inhibition of fibrinolysis (10 mg l-1 ), and perioperative blood loss. METHODS: Data were obtained from a prospective, double-blind, parallel-arm, randomized superiority study in hip arthroplasty. Patients received a preoperative intravenous bolus of TXA 1 g followed by a continuous infusion of either TXA 1 g or placebo over 8 h...
October 26, 2017: British Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/29189568/tranexamic-acid-decreases-visible-and-hidden-blood-loss-without-affecting-prethrombotic-state-molecular-markers-in-transforaminal-thoracic-interbody-fusion-for-treatment-of-thoracolumbar-fracture-dislocation
#19
Wentao Wang, Kun Duan, Minjie Ma, Yong Jiang, Tuanjiang Liu, Jijun Liu, Dingjun Hao
STUDY DESIGN: A randomized, double-blind, placebo-controlled clinical trial OBJECTIVE.: To evaluate the efficacy and safety of tranexamic acid (TXA) administered during the surgical correction of thoracolumbar fracture-dislocation SUMMARY OF BACKGROUND DATA.: Thoracolumbar fracture-dislocation surgery is generally associated with substantial blood loss and a high risk of deep vein thrombosis (DVT). TXA has been shown to improve hemostasis in surgical procedures. METHODS: We investigated 80 patients with thoracolumbar fracture-dislocation who underwent transforaminal thoracic interbody fusion (TTIF) between March 2014 and December 2016...
November 17, 2017: Spine
https://www.readbyqxmd.com/read/29174746/evaluating-the-effect-on-mortality-of-a-no-tranexamic-acid-txa-policy-for-cardiovascular-surgery
#20
Takuma Maeda, Takuma Ishihara, Shigeki Miyata, Kizuku Yamashita, Hiroaki Sasaki, Junjiro Kobayashi, Yoshihiko Ohnishi, Kunihiro Nishimura, Ayumi Shintani, Hiroyasu Iso
OBJECTIVES: The authors stopped using tranexamic acid (TXA) in April 2013. The present study aimed to examine the impact of a "no-TXA-use" policy by comparing the adverse effects of TXA and clinical outcomes before and after the policy change in patients undergoing cardiovascular surgery. DESIGN: A single center retrospective cohort study. SETTING: A single cardiovascular center. PARTICIPANTS: Patients undergoing cardiovascular surgery between January 2008 and July 2015 (n = 3,535)...
October 13, 2017: Journal of Cardiothoracic and Vascular Anesthesia
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