Comparison of topical fibrin spray and tranexamic acid on blood loss after total knee replacement

Abstract

We performed a randomised, controlled trial involving 150 patients with a pre-operative level of haemoglobin of 13.0 g/dl or less, to compare the effect of either topical fibrin spray or intravenous tranexamic acid on blood loss after total knee replacement. A total of 50 patients in the topical fibrin spray group had 10 ml of the reconstituted product applied intra-operatively to the operation site. The 50 patients in the tranexamic acid group received 500 mg of tranexamic acid intravenously five minutes before deflation of the tourniquet and a repeat dose three hours later, and a control group of 50 patients received no pharmacological intervention. There was a significant reduction in the total calculated blood loss for those in the topical fibrin spray group (p = 0.016) and tranexamic acid group (p = 0.041) compared with the control group, with mean losses of 1190 ml (708 to 2067), 1225 ml (580 to 2027), and 1415 ml (801 to 2319), respectively. The reduction in blood loss in the topical fibrin spray group was not significantly different from that achieved in the tranexamic acid group (p = 0.72).

Is Intraarticular Administration of Tranexamic Acid Better than Its Intravenous Administration in Reducing Blood loss after total Knee Arthroplasty?

“…Blood transfusion rates and drain outputs were also less but not much significant. In our study the total blood loss for the intraarticular administration group or patients is lower than most trials (1,020 as compared to 1,301 for Alvarez et al, [5] and 1,225 for Molloy et al, [18] ). The drain output was also less than most studies conducted (260 mL as compared to 385 mL of Good et al, [17] and 478 for Zhang et al [19] ).…”

Tranexamic Acid Reduces Blood Loss and Blood Transfusion after TKA: A Prospective Randomized Controlled Trial

“…A meta-analysis of nine randomized controlled trials concluded the use of tranexamic acid for patients undergoing TKA reduced the requirement for allogenic blood transfusion [8]. More recently, a study of topical fibrin spray and tranexamic acid on blood loss after TKA showed similar reduction in the total calculated blood loss for patients treated either way when compared with a control group [35].…”

Use of Tranexamic Acid during Total Endoprosthetic Replacement of the Hip Joint

“…Некоторые исследователи показали, что при использовании транексамовой кис лоты объём кровопотери был меньше на 50% [5], по данным других авторов -25% [6,7]. Однако, эти раз личия могут иметь принципиальный характер, т. к., если правы первые, то применение ТК предполагает необходимость в гемотрансфузии, тогда как умень шение кровопотери до 50% по отношению к кон трольной группе, позволит полностью отказаться от переливания компонентов крови.…”

“…в 1962 году [1]. Кровосберегающий эффект транексамо вой кислоты, по данным ряда авторов, варьирует от 25 до 50% при тотальном эндопротезировании тазобедрен ного сустава [5][6][7].…”