Intravenous administration of tranexamic acid in total hip arthroplasty does not change the blood coagulopathy: a prospective thrombelastography analysis.

Abstract

OBJECTIVE:

Despite the wide use of tranexamic acid (TXA) in the perioperative period of total hip arthroplasty (THA), whether the hemostatic state changes after the application of intravenous (IV)-TXA are still unknown. The aim of this study was to investigate whether IV administration of TXA changes the blood coagulation following primary THA via thrombelastography (TEG) analysis and conventional laboratory tests.

METHODS:

A total of 174 patients who underwent primary THA from September 2016 to July 2018 were selected. They were randomly divided into two groups, 86 patients with IV administration of 15 mg/kg TXA and 88 controls without TXA usage. Demographic data, TEG paremeters, d-dimer levels, fibrin degradation products, hemoglobin, hematocrit concentration, platelet, transfusion rates, perioperative blood loss, and the occurrence of deep vein thrombosis were collected. TEG and conventional laboratory tests were performed the day before operation, the first day after operation, and seventh day after operation.

RESULTS:

There were no differences with regard to TEG or conventional laboratory tests between the two groups (p > 0.05). The total blood loss and drain blood loss in the TXA group were significantly lower than those in the control group (p < 0.05). The transfusion rates and the volume of blood transfusion of the control group were higher than those of the TXA group (p < 0.05).

CONCLUSION:

The administration of IV-TXA resulted in a significant reduction in total blood loss, transfusion volumes, and transfusion rates without the increase of thromboembolic complications. Moreover, it was confirmed that TXA would not change the coagulation via the TEG analysis.

• Authors: Xing-Chen Zhang, Ma-Ji Sun, Sheng Pan, Min Rui, Feng-Chao Zhao, Guo-Chun Zha, Yong Pang, Xin Zheng, Kai-Jin Guo
• Journal: Journal of orthopaedic surgery (Hong Kong) (J Orthop Surg (Hong Kong)) 2020 Sep-Dec Vol. 28 Issue 3 Pg. 2309499020959516 ISSN: 2309-4990 [Electronic] England
• PMID: 32985369 (Publication Type: Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)

Chemical References

• Antifibrinolytic Agents
• Biomarkers
• Fibrin Fibrinogen Degradation Products
• Hemoglobins
• fibrin fragment D
• Tranexamic Acid

Topics

• Adult
• Aged
• Aged, 80 and over
• Antifibrinolytic Agents (administration & dosage)
• Arthroplasty, Replacement, Hip (methods)
• Biomarkers (blood)
• Blood Loss, Surgical (prevention & control)
• Blood Transfusion
• Female
• Fibrin Fibrinogen Degradation Products (metabolism)
• Hemoglobins (metabolism)
• Humans
• Infusions, Intravenous
• Male
• Middle Aged
• Prospective Studies
• Thrombelastography (methods)
• Thrombosis (blood, prevention & control)
• Tranexamic Acid (administration & dosage)