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JOURNAL ARTICLE
Ryogo Yoshii, Yuya Takahashi, Teiji Sawa, Fumimasa Amaya, Satoru Ogawa
A 61-year-old woman with chronic renal dysfunction was scheduled to undergo aortic valve replacement. After a bolus of 1 g tranexamic acid (TXA), the TPA (tissue-plasminogen activator)-test result with the ClotPro system demonstrated extensive inhibition of fibrinolysis. Plasma TXA level decreased from 71 to 25 μg/dL at 6 hours postoperatively; however, no further decrease was observed. Although TXA levels dropped to 6.9 μg/dL after hemodialysis on postoperative day (PoD) 1, fibrinolytic shutdown on the TPA-test remained unchanged until PoD 2...
May 1, 2023: A&A Practice
#22
RANDOMIZED CONTROLLED TRIAL
Maura Marcucci, Thomas W Painter, David Conen, Vladimir Lomivorotov, Daniel I Sessler, Matthew T V Chan, Flavia K Borges, Kate Leslie, Emmanuelle Duceppe, María José Martínez-Zapata, Chew Yin Wang, Denis Xavier, Sandra N Ofori, Michael Ke Wang, Sergey Efremov, Giovanni Landoni, Ydo V Kleinlugtenbelt, Wojciech Szczeklik, Denis Schmartz, Amit X Garg, Timothy G Short, Maria Wittmann, Christian S Meyhoff, Mohammed Amir, David Torres, Ameen Patel, Kurt Ruetzler, Joel L Parlow, Vikas Tandon, Edith Fleischmann, Carisi A Polanczyk, Andre Lamy, Raja Jayaram, Sergey V Astrakov, William Ka Kei Wu, Chao Chia Cheong, Sabry Ayad, Mikhail Kirov, Miriam de Nadal, Valery V Likhvantsev, Pilar Paniagua, Hector J Aguado, Kamal Maheshwari, Richard P Whitlock, Michael H McGillion, Jessica Vincent, Ingrid Copland, Kumar Balasubramanian, Bruce M Biccard, Sadeesh Srinathan, Samandar Ismoilov, Shirley Pettit, David Stillo, Andrea Kurz, Emilie P Belley-Côté, Jessica Spence, William F McIntyre, Shrikant I Bangdiwala, Gordon Guyatt, Salim Yusuf, P J Devereaux
BACKGROUND: Among patients having noncardiac surgery, perioperative hemodynamic abnormalities are associated with vascular complications. Uncertainty remains about what intraoperative blood pressure to target and how to manage long-term antihypertensive medications perioperatively. OBJECTIVE: To compare the effects of a hypotension-avoidance and a hypertension-avoidance strategy on major vascular complications after noncardiac surgery. DESIGN: Partial factorial randomized trial of 2 perioperative blood pressure management strategies (reported here) and tranexamic acid versus placebo...
May 2023: Annals of Internal Medicine
#23
RANDOMIZED CONTROLLED TRIAL
Hamid Bigdelian, Minoo Montazeri, Mohsen Sedighi, Mojtaba Mansouri, Alireza Amanollahi
INTRODUCTION: Postoperative bleeding is a common complication in congenital heart surgery. We aimed to evaluate effects of topical and intravenous tranexamic acid (TXA) administration on postoperative hemoglobin and bleeding in children with acyanotic congenital heart disease (CHD). METHODS: In this randomized clinical trial, 50 acyanotic CHD children were allocated into two groups of topical (n = 25) and infusion (n = 25). Children in the infusion group were given intravenous TXA 50 mg/kg-1 after sternotomy...
August 2023: Journal of Surgical Research
#24
MULTICENTER STUDY
Pascal Colson, Jean-Luc Fellahi, Philippe Gaudard, Sophie Provenchère, Bertrand Rozec
INTRODUCTION: The European Medicines Agency restored aprotinin (APR) use for preventing blood loss in patients undergoing isolated coronary artery bypass graft (iCABG) in 2016 but requested the collection of patient and surgery data in a registry (NAPaR). The aim of this analysis was to evaluate the impact of APR reintroduction in France on the main hospital costs (operating room, transfusion and intensive unit stay) compared to the current use of tranexamic acid (TXA), which was the only antifibrinolytic available before APR reinstatement...
April 2023: Advances in Therapy
#25
JOURNAL ARTICLE
Anair Beverly, Giok Ong, Catherine Kimber, Josie Sandercock, Carolyn Dorée, Nicky J Welton, Peter Wicks, Lise J Estcourt
BACKGROUND: Vascular surgery may be followed by internal bleeding due to inadequate surgical haemostasis, abnormal clotting, or surgical complications. Bleeding ranges from minor, with no transfusion requirement, to massive, requiring multiple blood product transfusions. There are a number of drugs, given systemically or applied locally, which may reduce the need for blood transfusion. OBJECTIVES: To assess the effectiveness and safety of anti-fibrinolytic and haemostatic drugs and agents in reducing bleeding and the need for blood transfusion in people undergoing major vascular surgery or vascular procedures with a risk of moderate or severe (> 500 mL) blood loss...
February 17, 2023: Cochrane Database of Systematic Reviews
#26
REVIEW
Marjorie R Liggett, Ali Amro, Moeun Son, Steven Schwulst
INTRODUCTION: Trauma during pregnancy is the leading cause of non-obstetric maternal death and complicates up to 5%-7% of pregnancies. This systematic review without meta-analysis explores the current literature regarding the assessment and management of pregnant trauma patients to provide evidence-based recommendations to guide the general surgeon regarding the prognostic value of laboratory testing including Kleihauer-Betke testing, duration of maternal and fetal monitoring, the use of tranexamic acid, the safety of radiographic studies, and the utility of perimortem cesarean section to improve maternal and fetal mortality...
May 2023: Journal of Surgical Research
#27
LETTER
Andreas Koster, Nikolai Hulde, Armin Zittermann
No abstract text is available yet for this article.
January 3, 2023: JAMA
#28
LETTER
Jia Shi, Chenghui Zhou, Zhe Zheng
No abstract text is available yet for this article.
January 3, 2023: JAMA
#29
REVIEW
Yiyuan Sun, Dan Xiao, Weili Fu, Wufeng Cai, Xihao Huang, Qi Li, Jian Li
BACKGROUND: Visual clarity during shoulder arthroscopy can ensure an efficient and effective performance of the procedure, and it is highly related to bleeding without a tourniquet. Tranexamic acid (TXA) is widely used in adult reconstruction procedures; however, its use in shoulder arthroscopic operations is a relatively novel topic. PURPOSE: To analyze the available literature on visual clarity, blood loss, pain control, functional outcomes, and complications after the administration of tranexamic acid in shoulder arthroscopic surgery...
November 22, 2022: Journal of Clinical Medicine
#30
RANDOMIZED CONTROLLED TRIAL
Celaleddin Bildik, Tuna Pehlivanoglu
BACKGROUND: Tranexamic acid (TXA) has been widely used in orthopedic surgery with the aim of reducing intraoperative and postoperative bleeding, as well as bleeding-related complications. The purpose of this study was to assess whether intra-articular use of TXA during arthroscopic rotator cuff tear (RCT) repair could improve visual clarity, shorten the duration of the operation, and provide superior pain management as compared with placebo. METHODS: We conducted a prospective, randomized, double-blind, placebo-controlled study...
February 2023: Journal of Shoulder and Elbow Surgery
#31
JOURNAL ARTICLE
J Grabert, M Velten
No abstract text is available yet for this article.
October 28, 2022: Anaesthesiologie
#32
Khalid Abbas Owish Suker, Muna Omer Mohamed Elatta, Mohmmed Mahmmoud Fadelallah Eljack, Abdelrahman H Abdelmoneim, Hiba Awadelkareem Osman Fadl, Ghazi Gasmalla Mohamed
INTRODUCTION: Inadvertent drug administration stays one of the reasons for avoidable morbidity and mortality complications around the globe. This report will talk about a case of inadvertent Intra-thecal Tranexamic Acid injection for a myomectomy operation, which ultimately leads to potential complications for patients. CASE PRESENTATION: A 33-year-old HIV-positive woman with dysmenorrhea for two years was diagnosed with uterine fibroids and scheduled for a myomectomy...
October 2022: Annals of Medicine and Surgery
#33
REVIEW
Chun-Mei Xie, Yun-Tai Yao, Li-Xian He, Ke Yang
OBJECTIVE: This study aims to evaluate the anti-inflammatory effect of tranexamic acid (TXA) on adult cardiac surgical patients. METHODS: PubMed, Embase, Ovid, Web of Science, CNKI, VIP, and WANFANG databases were systematically searched using the related keywords for cardiac surgical randomized controlled trials (RCTs) published from their inception to February 1, 2022. The primary outcomes were postoperative inflammatory biomarkers levels. The secondary outcomes were postoperative systemic inflammatory response syndrome and other major postoperative outcomes...
2022: Frontiers in Surgery
#34
REVIEW
Kai Zacharowski, Heinz Zoller, Andrea U Steinbicker
PURPOSE OF REVIEW: The particular fields within patient blood management (PBM) and patient safety reviewed here include novel insights into bleeding therapy, autologous cell salvage, and perioperative anemia therapy. RECENT FINDING: World Health Organization has published that implementation of PBM is important but has not yet been performed in all hospitals. Two antibodies that mimic the function of FVIII, Emicizumab, and Mim8 have been developed. Tranexamic acid (TXA) has been investigated further in patients with hip surgery and shows reduction of bleeding...
December 1, 2022: Current Opinion in Anaesthesiology
#35
JOURNAL ARTICLE
Rohan Lynham, Sarah Preissler, Nicholas J Lightfoot, Joanna Coates
CASE PRESENTATION: A 70-year-old women presented to a regional hospital after a fall, resulting in a periprosthetic femoral fracture. Preoperative echocardiogram was ordered to investigate a cardiac murmur, and unexpectedly, a significant regional wall abnormality was found. Further repeat electrocardiograph and troponin blood biomarker analysis demonstrated the patient had suffered an acute type 1 myocardial infarction after admission to the ward, without exhibiting classical ischemic cardiac symptoms...
April 1, 2022: JBJS Case Connector
#36
JOURNAL ARTICLE
Katherine Schertz, Oliver Karam, Michelle Demetres, Samantha Mayadunna, David Faraoni, Marianne E Nellis
OBJECTIVES: To determine the effect of intraoperative antifibrinolytics, including tranexamic acid (TXA), aminocaproic acid (EACA), or aprotinin, on bleeding in children undergoing cardiac surgery with cardiopulmonary bypass (CPB). DATA SOURCES: Relevant articles were systematically searched from Ovid MEDLINE, Ovid EMBASE, CINAHL, Cochrane Library, and Web of Science to November 15, 2021. STUDY SELECTION: Abstracts were screened, and full texts were reviewed using predetermined inclusion and exclusion criteria using the Preferred Reporting Items for Systematic Reviews and Meta-analyses reporting guideline...
November 1, 2022: Pediatric Critical Care Medicine
#37
REVIEW
Prakash A Patel, Julie A Wyrobek, Alexander J Butwick, Evan G Pivalizza, Gregory M T Hare, C David Mazer, Susan M Goobie
Tranexamic acid (TXA) is a potent antifibrinolytic with documented efficacy in reducing blood loss and allogeneic red blood cell transfusion in several clinical settings. With a growing emphasis on patient blood management, TXA has become an integral aspect of perioperative blood conservation strategies. While clinical applications of TXA in the perioperative period are expanding, routine use in select clinical scenarios should be supported by evidence for efficacy. Furthermore, questions regarding optimal dosing without increased risk of adverse events such as thrombosis or seizures should be answered...
September 1, 2022: Anesthesia and Analgesia
#38
JOURNAL ARTICLE
Xiao Wang, Ling Li, Lixian He, Yuntai Yao
Tranexamic acid (TXA) is one of the most commonly used antifibrinolytic agents for surgical patients. However, the effect of TXA on myocardial injury remains controversial. We systemically reviewed literature regarding the effectiveness of TXA on myocardial injury in patients who have undergone a cardiac surgery. We included all randomized controlled trials (RCTs) comparing TXA and control (saline) in cardiac surgical patients. Relevant studies were identified by a comprehensive electronic literature search from database inception to 15 August 2021...
December 1, 2022: Blood Coagulation & Fibrinolysis: An International Journal in Haemostasis and Thrombosis
#39
RANDOMIZED CONTROLLED TRIAL
Jia Shi, Chenghui Zhou, Wei Pan, Hansong Sun, Sheng Liu, Wei Feng, Weijian Wang, Zhaoyun Cheng, Yang Wang, Zhe Zheng
IMPORTANCE: Tranexamic acid is recommended for reducing blood loss and transfusion in cardiac surgery. However, it remains unknown whether a high dose of tranexamic acid provides better blood-sparing effect than a low dose without increasing the risk of thrombotic complications or seizures in cardiac surgery. OBJECTIVE: To compare the efficacy and adverse events of high-dose vs low-dose tranexamic acid in patients undergoing cardiac surgery with cardiopulmonary bypass...
July 26, 2022: JAMA
#40
JOURNAL ARTICLE
Robert E Dannemiller, Danielle M Knowles, Bryan M Cook, Melanie Z Goodberlet, Julie M Kelly, Rhynn Malloy
BACKGROUND: Antifibrinolytic agents, tranexamic acid (TXA) and epsilon-aminocaproic acid (EACA), are often used during cardiac surgery to decrease the number of allogenic blood transfusions and to prevent perioperative bleeding. Weight-based TXA dosing regimens have been compared to fixed-dose regimens of EACA with variable outcomes in perioperative blood product transfusions and chest tube output. Serious adverse events, including seizures, have been reported with higher doses of TXA...
October 2022: Journal of Cardiac Surgery
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