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https://www.readbyqxmd.com/read/27907937/tranexamic-acid-for-trauma-resuscitation-in-the-united-states-of-america
#1
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
#2
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
#3
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
https://www.readbyqxmd.com/read/27894501/tranexamic-acid-update-in-trauma
#4
REVIEW
Ricardo J Ramirez, Philip C Spinella, Grant V Bochicchio
Following results from the CRASH-2 trial, tranexamic acid (TXA) gained considerable interest for the treatment of hemorrhage in trauma patients. Although TXA is effective at reducing mortality in patients presenting within 3 hours of injury, optimal dosing, timing of administration, mechanism, and pharmacokinetics require further elucidation. The concept of fibrinolysis shutdown in hemorrhagic trauma patients has prompted discussion of real-time viscoelastic testing and its potential role for appropriate patient selection...
January 2017: Critical Care Clinics
https://www.readbyqxmd.com/read/27886354/a-retrospective-analysis-of-the-merits-and-challenges-associated-with-simultaneous-bilateral-tha-using-the-direct-anterior-approach
#5
Matthew L Brown, Johannes F Plate, David C Holst, Daniel N Bracey, Matthew W Bullock, Jason E Lang
INTRODUCTION: 15%-20% of patients presenting for total hip arthroplasty (THA) have bilateral disease. While simultaneous bilateral THA is of interest to patients and surgeons, debate persists regarding its merits. The majority of previous reports on simultaneous bilateral THA involve patients in the lateral decubitus position, which require repositioning, prepping and draping, and exposure of a fresh wound to pressure and manipulation for the contralateral THA. The purpose of this study was to compare complications, component position, and financial parameters for simultaneous versus staged bilateral THAs using the direct anterior approach (DAA)...
November 14, 2016: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
https://www.readbyqxmd.com/read/27885960/high-dose-tranexamic-acid-reduces-intraoperative-and-postoperative-blood-loss-in-posterior-lumbar-interbody-fusion
#6
Junichi Kushioka, Tomoya Yamashita, Shinya Okuda, Takafumi Maeno, Tomiya Matsumoto, Ryoji Yamasaki, Motoki Iwasaki
OBJECTIVE Tranexamic acid (TXA), a synthetic antifibrinolytic drug, has been reported to reduce blood loss in orthopedic surgery, but there have been few reports of its use in spine surgery. Previous studies included limitations in terms of different TXA dose regimens, different levels and numbers of fused segments, and different surgical techniques. Therefore, the authors decided to strictly limit TXA dose regimens, surgical techniques, and fused segments in this study. There have been no reports of using TXA for prevention of intraoperative and postoperative blood loss in posterior lumbar interbody fusion (PLIF)...
November 25, 2016: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/27872771/tranexamic-acid-an-exceedingly-rare-cause-of-anaphylaxis-during-anaesthesia
#7
R A Bansal, A Nicholas, A S Bansal
Tranexamic acid (TXA) allergy is extremely rare. An 80-year-old woman without prior exposure to TXA underwent elective knee replacement. Shortly after induction of anaesthesia and intravenous TXA, she developed hypotension, tachycardia, and facial erythema accompanied by a raised serum tryptase. Later, skin prick and intradermal testing confirmed positive responses to TXA in high dilution and with negative results to the other drugs used. While neuromuscular blocking agents, opiates, and antibiotics remain the most frequent cause of anaphylaxis during anaesthesia, allergy to TXA should always be borne in mind and requires skin testing for confirmation as there are presently no blood tests available...
2016: Case Reports in Immunology
https://www.readbyqxmd.com/read/27871586/comparative-effectiveness-of-epsilon-aminocaproic-acid-and-tranexamic-acid-on-postoperative-bleeding-following-cardiac-surgery-during-a-national-medication-shortage
#8
Kevin P Blaine, Christopher Press, Ken Lau, Jan Sliwa, Vidya K Rao, Charles Hill
STUDY OBJECTIVE: The aim of this study was to compare the effectiveness of epsilon-aminocaproic acid (εACA) and tranexamic acid (TXA) in contemporary clinical practice during a national medication shortage. DESIGN: A retrospective cohort study. SETTING: The study was performed in all consecutive cardiac surgery patients (n=128) admitted to the cardiac-surgical intensive care unit after surgery at a single academic center immediately before and during a national medication shortage...
December 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27856355/combined-intravenous-and-topical-tranexamic-acid-versus-intravenous-use-alone-in-primary-total-knee-and-hip-arthroplasty-a-meta-analysis-of-randomized-controlled-trials
#9
REVIEW
Jie Shang, Haibo Wang, Bai Zheng, Min Rui, Yehua Wang
OBJECTIVE: The tranexamic acid (TXA) can reduce surgical perioperative blood loss. However, the optimal regimen of tranexamic acid remains controversial. The purpose of this meta-analysis was to compare the efficacy and safety of combined intravenous and topical tranexamic acid versus intravenous use alone in primary total knee and hip arthroplasty. METHODS: PubMed, EMbase, Cochrane library and OVID were searched. Eligible randomized controlled trials (RCTs) evaluating combined intravenous and topical TXA versus intravenous alone in primary total knee and hip arthroplasty were included...
November 14, 2016: International Journal of Surgery
https://www.readbyqxmd.com/read/27843042/low-risk-of-thromboembolic-events-after-routine-administration-of-tranexamic-acid-in-hip-and-knee-arthroplasty
#10
Rune V Madsen, Christian S Nielsen, Thomas Kallemose, Henrik Husted, Anders Troelsen
BACKGROUND: The blood-conserving effect of intravenous (IV) tranexamic acid (TXA) is well-documented for total hip arthroplasty (THA) and total knee arthroplasty (TKA). However, the risk of thromboembolic (TE) events after routine use of TXA is unclear and the safety profile is debated. This retrospective study investigates patient characteristics, occurrences, and predictors of TE events after routine administration of IV TXA in THA and TKA. METHODS: Three thousand one hundred fifty-nine THA or TKA procedures performed from 2007-2013 at our institution were included...
October 20, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/27837327/topical-versus-intravenous-tranexamic-acid-in-total-knee-arthroplasty-a-meta-analysis-of-randomized-controlled-trials
#11
Shangquan Wang, Xinxia Gao, Yan An
BACKGROUND: Tranexamic acid (TXA) is an antifibrinolytic drug used widely to prevent bleeding in total knee arthroplasty (TKA). However, there is no consensus regarding the administration routes of TXA. This meta-analysis aimed to investigate the efficacy of topical (intra-articular) versus intravenous TXA in reducing blood loss and transfusion rate in patients who underwent TKA. METHOD: We conducted a Pubmed, EMBASE, Cochrane Library, and Web of Science search for randomized controlled trials (RCTs) comparing topical versus intravenous TXA in TKA...
November 11, 2016: International Orthopaedics
https://www.readbyqxmd.com/read/27832317/influence-of-single-dose-intravenous-tranexamic-acid-on-total-hip-replacement-a%C3%A2-study-on-transfusions-collateral-complications-and-readmissions
#12
A Fígar, S Mc Loughlin, P A Slullitel, W Scordo, M A Buttaro
INTRODUCTION: To determine the effects of tranexamic acid (TXA) on transfusions in patients undergoing hip replacement with a hybrid or cementless prosthesis. METHODS: A group of 172 consecutive patients aged 18 years or older who underwent elective hip replacement with uncemented or hybrid prostheses, undergoing surgery between January 2012 and January 2014 by the same primary surgeon and anesthesiologist, were retrospectively included. TXA (1 g) was administered immediately before incision in the TXA group...
November 10, 2016: Der Orthopäde
https://www.readbyqxmd.com/read/27827518/transfusion-requirements-in-burn-patients-undergoing-primary-wound-excision-effect-of-tranexamic-acid
#13
Ana Domínguez, Estíbaliz Alsina, Luis Landín, Javier F García-Miguel, Cesar Casado, Fernando Gilsanz
BACKGROUND: Early excision of burn wounds is the standard approach for burns, but it is usually associated with the need of allogeneic blood transfusion. Our aim was to determine if intravenous administration of tranexamic acid (TXA) was able to reduce packed red blood cell (pRBC) transfusion requirements in burn patients. METHODS: We conducted a retrospective cohort study of 2 consecutive series of severely burned patients (≥ 20% total body surface are) admitted for primary burn surgery...
November 9, 2016: Minerva Anestesiologica
https://www.readbyqxmd.com/read/27816438/comparison-of-tranexamic-acid-plasma-concentrations-when-administered-via-intraosseous-and-intravenous-routes
#14
Søren R Boysen, Jessica M Pang, John R Mikler, Cameron G Knight, Hugh A Semple, Nigel A Caulkett
INTRODUCTION: There is a lack of information regarding intraosseous (IO) administration of tranexamic acid (TXA). Our hypothesis was that a single bolus IO injection of TXA will have a similar pharmacokinetic profile to TXA administered at the same dose IV. METHODS: Sixteen male Landrace cross swine (mean body weight 27.6±2.6kg) were divided into an IV group (n=8) and an IO group (n=8). Each animal received 30mg/kg TXA via an IV or IO catheter, respectively. Jugular blood samples were collected for pharmacokinetic analysis over a 3h period...
October 26, 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27812635/staphylococcal-superantigen-specific-ige-antibodies-degree-of-sensitization-and-association-with-severity-of-asthma
#15
José Elabras, Fernanda Carvalho de Queiroz Mello, Omar Lupi, Blanca Elena Rios Gomes Bica, José Angelo de Souza Papi, Alfeu Tavares França
Objective: To determine the presence of staphylococcal superantigen-specific IgE antibodies and degree of IgE-mediated sensitization, as well as whether or not those are associated with the severity of asthma in adult patients. Methods: This was a cross-sectional study involving outpatients with asthma under treatment at a tertiary care university hospital in the city of Rio de Janeiro, Brazil. Consecutive patients were divided into two groups according to the severity of asthma based on the Global Initiative for Asthma criteria: mild asthma (MA), comprising patients with mild intermittent or persistent asthma; and moderate or severe asthma (MSA)...
September 2016: Jornal Brasileiro de Pneumologia: Publicaça̋o Oficial da Sociedade Brasileira de Pneumologia e Tisilogia
https://www.readbyqxmd.com/read/27806184/antifibrinolytic-therapy-to-reduce-haemoptysis-from-any-cause
#16
REVIEW
Gabriela Prutsky, Juan Pablo Domecq, Carlos A Salazar, Roberto Accinelli
BACKGROUND: Haemoptysis is a common pathology around the world, occurring with more frequency in low-income countries. It has different etiologies, many of which have infectious characteristics. Antifibrinolytic agents are commonly used to manage bleeding from different sources, but their usefulness in pulmonology is unclear. OBJECTIVES: To evaluate the effectiveness and safety of antifibrinolytic agents in reducing the volume and duration of haemoptysis in adult and paediatric patients...
November 2, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27769593/viscoelastic-properties-of-orthodontic-adhesives-used-for-lingual-fixed-retainer-bonding
#17
D Papadogiannis, A Iliadi, T G Bradley, N Silikas, G Eliades, T Eliades
OBJECTIVE: To evaluate the viscoelastic properties of two experimental BPA-free and one BisGMA-based orthodontic resin composite adhesives for bonding fixed retainers. METHODS: A commercially available BisGMA-based (TXA: Transbond LR) and two bisphenol A-free experimental adhesives (EXA and EXB) were included in the study. The viscoelastic behavior of the adhesives was evaluated under static and dynamic conditions at dry and wet states and at various temperatures (21, 37, 50°C)...
October 18, 2016: Dental Materials: Official Publication of the Academy of Dental Materials
https://www.readbyqxmd.com/read/27765582/major-liver-resection-systemic-fibrinolytic-activity-and-the-impact-of-tranexamic-acid
#18
Paul J Karanicolas, Yulia Lin, Jordan Tarshis, Calvin H L Law, Natalie G Coburn, Julie Hallet, Barto Nascimento, Janusz Pawliszyn, Stuart A McCluskey
BACKGROUND: Hyperfibrinolysis may occur due to systemic inflammation or hepatic injury that occurs during liver resection. Tranexamic acid (TXA) is an antifibrinolytic agent that decreases bleeding in various settings, but has not been well studied in patients undergoing liver resection. METHODS: In this prospective, phase II trial, 18 patients undergoing major liver resection were sequentially assigned to one of three cohorts: (i) Control (no TXA); (ii) TXA Dose I - 1 g bolus followed by 1 g infusion over 8 h; (iii) TXA Dose II - 1 g bolus followed by 10 mg/kg/hr until the end of surgery...
October 17, 2016: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/27760536/a-comparative-retrospective-study-of-peri-articular-and-intra-articular-injection-of-tranexamic-acid-for-the-management-of-postoperative-blood-loss-after-total-knee-arthroplasty
#19
Zhenyang Mao, Bing Yue, You Wang, Mengning Yan, Kerong Dai
BACKGROUND: Intra-articular injection of tranexamic acid (TXA) is known to be effective in controlling blood loss after total knee arthroplasty (TKA). However, this method has some disadvantages, such as TXA leakage due to soft tissue release. Peri-articular injection provides an alternative to intra-articular administration of TXA. This study aimed to evaluate the effects of peri-articular injection of TXA in reducing blood loss after TKA and compare them to those of intra-articular TXA injection...
October 19, 2016: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/27753568/compatibility-of-hydroxyethyl-starch-and-tranexamic-acid-for-battlefield-co-administration
#20
Nicholas M Studer, Ahmad H Yassin, Donald E Keen
INTRODUCTION: The current Tactical Combat Casualty Care Guidelines recommend tranexamic acid (TXA) administration for casualties in whom massive blood transfusion is anticipated. However, despite Hextend being the recommended resuscitation fluid, the guidelines recommend against using TXA with Hextend. This appears to be due to a concern about pharmaceutical compatibility, despite the absence of a direct study of compatibility in the literature. METHODS: Two solutions of Hextend and TXA were examined for compatibility...
October 2016: Military Medicine
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