Abstract | BACKGROUND: METHODS: Thirty children admitted for craniosynostosis surgery were randomised to combined intra- and postoperative TXA treatment or placebo. The primary endpoint was postoperative blood loss. Secondary endpoints included total blood loss, transfusion requirements, and clot stability evaluated by tissue plasminogen activator-stimulated clot lysis assay. RESULTS: TXA reduced postoperative blood loss by 18 ml kg-1 (95% confidence interval 8.9) and total blood loss from a mean of 52 ml kg-1 (standard deviation [SD]; 20) ml kg-1 to 28 (14) ml kg-1 (P<0.001). Intraoperative red blood cell (RBC) and fresh frozen plasma (FFP) transfusions were reduced in the treatment group from RBC 14.0 (5.2) ml kg-1 to 8.2 (5.1) ml kg-1 (P=0.01) and from FFP 13.0 (6.3) ml kg-1 to 7.8 (5.9) ml kg-1 (P=0.03). Postoperative RBC transfusion median was 5 (inter-quartile range [IQR] 0-6) ml kg-1 in the placebo group and 0 (0-5.7) ml kg-1 in the TXA group. Resistance to lysis was higher in the treatment group (P<0.001). CONCLUSIONS: Combined intra- and postoperative tranexamic acid treatment reduced postoperative and overall blood loss and transfusion requirements. Improved clot stability represents a possible mechanism for blood loss reduction.
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Authors | Christian Fenger-Eriksen, Alexander D'Amore Lindholm, Sven Erik Nørholt, Gorm von Oettingen, Mona Tarpgaard, Lisbeth Krogh, Niels Juul, Anne Mette Hvas, Mads Rasmussen |
Journal | British journal of anaesthesia
(Br J Anaesth)
Vol. 122
Issue 6
Pg. 760-766
(Jun 2019)
ISSN: 1471-6771 [Electronic] England |
PMID | 30952386
(Publication Type: Journal Article, Randomized Controlled Trial)
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Copyright | Copyright © 2019 British Journal of Anaesthesia. Published by Elsevier Ltd. All rights reserved. |
Chemical References |
- Antifibrinolytic Agents
- Tranexamic Acid
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Topics |
- Anesthesia, General
(methods)
- Antifibrinolytic Agents
(administration & dosage, therapeutic use)
- Blood Loss, Surgical
(prevention & control)
- Child, Preschool
- Craniosynostoses
(surgery)
- Double-Blind Method
- Erythrocyte Transfusion
- Female
- Fibrinolysis
(drug effects)
- Humans
- Infant
- Infusions, Intravenous
- Male
- Perioperative Care
(methods)
- Postoperative Hemorrhage
(prevention & control)
- Tranexamic Acid
(administration & dosage, therapeutic use)
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