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https://www.readbyqxmd.com/read/28338491/perioperative-management-of-blood-loss-in-spine-surgery
#1
Rabia Qureshi, Varun Puvanesarajah, Amit Jain, Hamid Hassanzadeh
Spine procedures are associated with high rates of blood loss which can result in a greater need for transfusions. Repeated exposure to blood products is associated with risks and adverse reactions such as transfusion-related acute lung injury, fluid shifting, and infections. With the higher number of spine procedures and the increasing open surgery times associated with difficult procedures, excessive blood loss has become more prevalent. Perioperative methods have been established to combat the excessive blood loss and decrease the need for blood products...
March 23, 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28338025/preventing-perioperative-bleeding-in-patients-with-inherited-bleeding-disorders
#2
Colin Watterson, Nicholas Beacher
Data sourcesCochrane Cystic Fibrosis and Genetic Disorders Group's Coagulopathies Trials Register, a regularly updated database informed by trials identified within electronic databases including MEDLINE. Further defined searches were undertaken in PubMed, Embase, The Cochrane Library, ClinicalTrials.gov and WHO International Clinical Trials Registry Platform. Additional hand searching of relevant journals and books of conference proceedings was undertaken.Study selectionRandomised and quasi-randomised controlled trials in people of all ages with haemophilia or VWD undergoing oral or dental procedures using antifibrinolytic agents (tranexamic acid (TXA) or epsilon aminocaproic acid (EACA)) to prevent perioperative bleeding compared to no intervention with or without placebo...
March 2017: Evidence-based Dentistry
https://www.readbyqxmd.com/read/28337652/corr-insights-%C3%A2-what-is-the-ideal-route-of-administration-of-tranexamic-acid-in-tka-a-randomized-controlled-trial
#3
Charles N Cornell
No abstract text is available yet for this article.
March 23, 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28336258/a-comparison-of-combined-intravenous-and-topical-administration-of-tranexamic-acid-with-intravenous-tranexamic-acid-alone-for-blood-loss-reduction-after-total-hip-arthroplasty-a-meta-analysis
#4
REVIEW
Xiangcheng Liu, Jinglong Liu, Ganghe Sun
BACKGROUND: The optimal dose and protocol of tranexamic acid (TXA) for reducing blood loss in total hip arthroplasty (THA) is controversial. Intravenous TXA (IV-TXA) and combined IV-TXA with topical TXA are the two common protocol after THA. A meta-analysis of randomized controlled trials (RCTs) to compare the efficacy and safety of combined IV and topical TXA with IV-TXA alone in reducing blood loss after THA. METHODS: PubMed, Medline, Embase, Web of Science, the Cochrane Library, China Wanfang database and Google database were searched from the inception to February 2017 to identify RCTs that comparing combined IV and topical TXA with IV-TXA alone for patients prepared for primary THA...
March 20, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28336035/effect-of-tranexamic-acid-on-transfusion-rates-following-total-joint-arthroplasty-a-cost-and-comparative-effectiveness-analysis
#5
REVIEW
Perry J Evangelista, Michael W Aversano, Emmanuel Koli, Lorraine Hutzler, Ifeoma Inneh, Joseph Bosco, Richard Iorio
Tranexamic acid (TXA) is used to reduce blood loss in orthopedic total joint arthroplasty (TJA). This study evaluates the effectiveness of TXA in reducing transfusions and hospital cost in TJA. Participants undergoing elective TJA were stratified into 2 cohorts: those not receiving and those receiving intravenous TXA. TXA decreased total hip arthroplasty (THA) transfusions from 22.7% to 11.9%, and total knee arthroplasty (TKA) from 19.4% to 7.0%. The average direct hospital cost reduction for THA and TKA was $3083 and $2582, respectively...
April 2017: Orthopedic Clinics of North America
https://www.readbyqxmd.com/read/28331851/predicting-factors-for-allogeneic-blood-transfusion-and-excessive-postoperative-blood-loss-after-single-low-dosage-intra-articular-tranexamic-acid-application-in-total-knee-replacement
#6
Paphon Sa-Ngasoongsong, Siwadol Wongsak, Noratep Kulachote, Pongsthorn Chanplakorn, Patarawan Woratanarat, Viroj Kawinwonggowit
Background. Recently, intra-articular tranexamic acid (IA-TXA) application has become a popular method for perioperative blood loss (PBL) reduction in total knee replacement (TKR). Nevertheless, through our knowledge, no previous studies had shown the correlation perioperative factors and the risk of excessive PBL or need of blood transfusion (BT) after IA-TXA. Materials and Methods. A retrospective study was conducted in patients underwent 299 primary TKRs, using IA-TXA, during 2-year period (2013-2014). Patient's characteristic and perioperative data were reviewed and collected...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28328682/early-tranexamic-acid-administration-ameliorates-the-endotheliopathy-of-trauma-and-shock-in-an-in-vitro-model
#7
Lawrence N Diebel, Jonathan V Martin, David M Liberati
BACKGROUND: Systemic vascular endothelial injury is a consequence of trauma-hemorrhagic shock (T/HS) which results in disturbances of coagulation, inflammation and endothelial barrier integrity. The effect of T/HS on the endothelium (Endotheliopathy of Trauma)[EoT] is of intense research interest and may lead to EoT directed therapies. Administration of tranexamic acid (TXA) in trauma patients is associated with a survival benefit and fewer complications if given early after injury. Mechanisms for this protective effect include the anti-fibrinolytic and anti-inflammatory effects of TXA...
March 21, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28326428/impact-of-postoperative-compression-dressing-using-polyethylene-foam-pad-on-the-multimodal-protocol-for-swelling-control-following-total-knee-arthroplasty-a-randomized-controlled-trial
#8
Satomi Kayamori, Sachiyuki Tsukada, Masako Sato, Kenichi Komata, Yumiko Isida, Motohiro Wakui
BACKGROUND: The multimodal approach is commonly applied to improve knee swelling after total knee arthroplasty. Although the use of a knee compression pad may improve knee swelling, its impact in the multimodal protocol remains unclear. METHODS: A total of 57 knees were randomly assigned to one of 2 groups receiving treatment with either a compression dressing using a polyethylene foam pad designed to effectively compress the postoperative knee combined with an elastic bandage or a compression dressing with use of an elastic bandage only...
December 2016: Arthroplasty Today
https://www.readbyqxmd.com/read/28326403/effects-of-tranexamic-acid-and-bipolar-sealer-alone-or-in-combination-in-primary-total-knee-arthroplasty-a-prospective-randomized-controlled-trial
#9
Alexandru Seviciu, Irwin Gross, Samreen Fathima, Stephen M Walsh
BACKGROUND: The purpose of this study was to compare 2 blood management interventions, tranexamic acid (TXA) and bipolar sealer system (BSS) used independently or in combination with a control group during primary total knee arthroplasty (TKA). METHODS: A total of 127 TKA patients were enrolled and randomized into 4 groups: Intravenous TXA plus the BSS (N = 29, group 1); TXA only (N = 29, group 2); BSS only (N = 31, group 3); and intravenous normal saline as a control group (N = 32, group 4)...
June 2016: Arthroplasty Today
https://www.readbyqxmd.com/read/28326178/introduction-of-cryobiopsies-in-the-diagnostics-of-interstitial-lung-diseases-experiences-in-a-referral-center
#10
Sissel Kronborg-White, Birgitte Folkersen, Torben Riis Rasmussen, Nina Voldby, Line Bille Madsen, Finn Rasmussen, Venerino Poletti, Elisabeth Bendstrup
Introduction: Transbronchial cryobiopsies (cTBB) has emerged as a new method for obtaining lung tissue biopsies in the diagnosis of interstitial lung diseases (ILDs). Until now, it has been used in a few highly specialized interventional centers and has shown promising results in obtaining a definite diagnosis of ILDs. Method: All patients undergoing a cTBB between November 2015 and June 2016 were included in this case series study. Data on patient demographics, high-resolution computed tomography patterns, size and number of biopsies, histology patterns, the contribution to a confident diagnosis and complications were registered...
2017: European Clinical Respiratory Journal
https://www.readbyqxmd.com/read/28323673/clinical-pearls-of-maternal-critical-care-part-2-sickle-cell-disease-in-pregnancy
#11
Vinod Patil, Gamunu Ratnayake, Galina Fastovets
PURPOSE OF REVIEW: The current review outlines the challenges in managing pregnant women with sickle-cell anemia, who are at risk of becoming critically ill during pregnancy. RECENT FINDINGS: Sickle obstetric patients pose unique challenges to the anesthetist and intensivist. We discuss the role of prophylactic transfusions for specific indications like acute anemia and twin pregnancies. The management and prevention of vaso-occlusive crises and chest crisis are also outlined...
March 18, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28321954/anaphylactic-reaction-to-tranexamic-acid-in-an-adolescent-undergoing-posterior-spinal-fusion
#12
Jennifer Chiem, Iskra Ivanova, Andrew Parker, Walter Krengel, Nathalia Jimenez
Tranexamic acid is an anti-fibrinolytic agent frequently used in pediatric surgery. Common side effects include nausea, flushing, and headache, but in rare instances, it may produce anaphylaxis; with only one previously reported case in a 72-year-old man. We report a case of a delayed anaphylactic reaction in a pediatric patient undergoing posterior spine fusion; and discuss the intraoperative management of the acute event, immunologic confirmation, and subsequent anesthetic approach.
March 21, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28319931/bet-1-tranexamic-acid-in-epistaxis-who-bloody-nose
#13
Nicola Penrose, Gabby May
A shortcut review was carried out to establish whether tranexamic acid is effective in controlling epistaxis. Three studies were directly relevant to the question. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of these studies are tabulated. The clinical bottom line is that there is not enough evidence to recommend tranexamic acid in the standard management of epistaxis.
November 2016: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28319822/comparison-of-intravenous-versus-topical-tranexamic-acid-in-primary-total-hip-and-knee-arthroplasty-an-updated-meta-analysis
#14
REVIEW
Jinwei Xie, Qinsheng Hu, Qiang Huang, Jun Ma, Yiting Lei, Fuxing Pei
BACKGROUND: The appropriate route for administering tranexamic acid in primary total hip (THA) and knee arthroplasty (TKA) remains controversial. The purpose of this meta-analysis was to compare the efficacy and safety of topical or intravenous tranexamic acid. METHODS: PubMed, EMBASE, and the Cochrane Library databases were systematically searched for randomized controlled trials (RCTs) comparing topical and intravenous tranexamic acid following primary THA or TKA...
March 10, 2017: Thrombosis Research
https://www.readbyqxmd.com/read/28318926/effectiveness-of-tranexamic-acid-for-reducing-intraoperative-bleeding-in-palatoplasties-a-randomized-clinical-trial
#15
Guilherme C Arantes, Rui Manoel R Pereira, Daniela B de Melo, Nivaldo Alonso, Maria do Carmo M B Duarte
BACKGROUND: Few data are available regarding blood loss during cleft palate surgery. This study assessed the effect of using tranexamic acid in the reduction of intraoperative bleeding. METHODS: A double-blind, randomized clinical trial compared intraoperative bleeding and the incidence of oronasal fistulas after palatoplasties in a control group that was given placebo and an intervention group that was given 10 mg/kg tranexamic acid followed by a continuous infusion of 1 mg/kg/h of the same until the end of surgery...
December 30, 2016: Journal of Cranio-maxillo-facial Surgery
https://www.readbyqxmd.com/read/28317031/effect-of-tranexamic-acid-on-coagulation-and-fibrinolysis-in-women-with-postpartum-haemorrhage-woman-etac-protocol-and-statistical-analysis-plan-for-a-randomized-controlled-trial
#16
Haleema Shakur, Bukola Fawole, Modupe Kuti, Oladapo Olayemi, Adenike Bello, Olayinka Ogunbode, Taiwo Kotila, Chris O Aimakhu, Sumaya Huque, Meghann Gregg, Ian Roberts
Background: Postpartum haemorrhage (PPH) is a leading cause of maternal death. Tranexamic acid has the potential to reduce bleeding and a large randomized controlled trial of its effect on maternal health outcomes in women with PPH (The WOMAN trial) is ongoing. We will examine the effect of tranexamic acid on fibrinolysis and coagulation in a subset of WOMAN trial participants. Methods. Adult women with clinically diagnosed primary PPH after vaginal or caesarean delivery are eligible for inclusion in the WOMAN trial...
December 16, 2016: Wellcome Open Res
https://www.readbyqxmd.com/read/28316839/tranexamic-acid-txa-in-trauma-patients-barriers-to-use-among-trauma-surgeons-and-emergency-physicians
#17
Abdulaziz Alburaih
Objective. Tranexamic Acid (TXA) is currently the only drug with prospective clinical evidence supporting its use in bleeding trauma patients. We sought to better understand the barriers preventing its use and elicit suggestions to further its use in trauma patients in the state of Maryland. Methods. This is a cross-sectional study. Results. The overall response rate was 38%. Half of all participants reported being familiar with the CRASH-2 trial and MATTERs study. Half reported being aware of TXA as part of their institution's massive transfusion protocol...
2017: Emergency Medicine International
https://www.readbyqxmd.com/read/28306626/pregnancy-and-delivery-in-a-woman-with-severe-haemophilia-a
#18
Jelena N Bodrozic, Predrag S Miljic, Danijela R Lekovic, Milos A Petronijevic, Darko A Antic, Mirjana M Mitrovic, Svetlana M Petronijevic-Vrzic, Irena S Djunic
Severe form of haemophilia in women is an extremely rare condition. Owing to the rarity of the disease there are no precise recommendations concerning the optimal management of pregnancy and delivery in these patients. We are reporting the clinical course and management of a 30-year-old woman with a severe form of haemophilia A (factor VIII <1 IU/dl) during her first pregnancy and delivery. Antepartum, she was treated on demand by FVIII concentrate and she delivered at 37 weeks of gestation by cesarean section...
March 16, 2017: Blood Coagulation & Fibrinolysis: An International Journal in Haemostasis and Thrombosis
https://www.readbyqxmd.com/read/28304315/using-antifibrinolytics-in-the-peripartum-period-concern-for-a-hypercoagulable-effect
#19
H K Ahmadzia, E L Lockhart, S M Thomas, I J Welsby, M R Hoffman, A H James, A P Murtha, G K Swamy, C A Grotegut
INTRODUCTION: Although antifibrinolytic agents are used to prevent and treat hemorrhage, there are concerns about a potential increased risk for peripartum venous thromboembolism. We sought to determine the impact of tranexamic acid and ɛ-aminocaproic acid on in vitro clotting properties in pregnancy. METHODS: Blood samples was obtained from healthy pregnant, obese, and preeclamptic pregnant women (n = 10 in each group) prior to delivery as well as from healthy non-pregnant controls (n = 10)...
March 16, 2017: Journal of Neonatal-perinatal Medicine
https://www.readbyqxmd.com/read/28304250/tranexamic-acid-and-supportive-measures-to-treat-wasting-marmoset-syndrome
#20
Takuro Yoshimoto, Kimie Niimi, Eiki Takahashi
Wasting marmoset syndrome (WMS) has high incidence and mortality rates and is one of the most important problems in captive common marmoset (Callithrix jacchus) colonies. Despite several reports on WMS, little information is available regarding its reliable treatment. We previously reported that marmosets with WMS had high serum levels of matrix metalloproteinase 9 (MMP9). MMP9 is thought to be a key enzyme in the pathogenesis of inflammatory bowel disease, the main disease state of WMS, and is activated by plasmin, a fibrinolytic factor...
December 1, 2016: Comparative Medicine
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