Effect of tranexamic acid on markers of inflammation in children undergoing craniofacial surgery

Fenger-Eriksen, Christian; Rasmussen, Mads; Juul, Niels; Krog, Jan; Hvas, Anne‐Mette

doi:10.1111/aas.13700

Cited by 4 publications

(20 citation statements)

References 22 publications

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“…19,[47][48][49][50] The majority of included studies were RCTs, [19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][35][36][37][38][39][40]43,44,[46][47][48][49][50] while five were cohort studies including a control group. 19,34,41,42,45 The participants in most of the articles were undergoing elective surgery (n ¼ 3,563) 19-39,41--47,49,50 of which 13 studies investigated total knee arthroplasty patients which, at least partly, is an inflammatory condition (n ¼ 1,918), 20,22,24,25,27,34,35,[37][38][39]42,...…”

Section: Resultsmentioning

confidence: 99%

“…19 The studies were grouped depending on the control group. Fourteen studies compared patients receiving TXA with a group receiving either placebo or no medication 19,20,25,26,29,30,32,34,36,40,42,[48][49][50] while 14 other studies compared different dosing schemes of TXA. [21][22][23][24]28,33,[37][38][39]41,43,44,46,47 Finally, five studies examined the difference of the inflammatory effect of TXA between different administration forms of TXA.…”

Section: Resultsmentioning

confidence: 99%

“…[21][22][23][24]28,33,[37][38][39]41,43,44,46,47 Finally, five studies examined the difference of the inflammatory effect of TXA between different administration forms of TXA. 21,27,31,35,45 Inflammatory Biomarkers ►Table 1 shows a summary of the 14 included studies that investigated inflammatory markers in TXA patients and compared them to either a group receiving placebo or no medication, [19][20][21]25,26,29,30,32,34,36,40,42,[48][49][50] while ►Table 2 presents a summary of 14 articles that investigated inflammatory biomarkers in surgical patients receiving TXA and compared them to a single group or several groups receiving either fewer or lower doses of TXA. [21][22][23][24]28,33,[37][38][39]41,43,44,46,...…”

Section: Resultsmentioning

confidence: 99%

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Tranexamic Acid and Its Potential Anti-Inflammatory Effect: A Systematic Review

Okholm

Krog

Hvas

2022

Semin Thromb Hemost

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Tranexamic acid (TXA) is an antifibrinolytic drug primarily used for reducing blood loss in patients with major bleedings. Animal and cell studies have shown that TXA might modulate the inflammatory response by either enhancing or inhibiting cytokine levels. Furthermore, recent human studies have found altered inflammatory biomarkers in patients receiving TXA when compared with patients who did not receive TXA. In this systematic review we investigated the effect of TXA on inflammatory biomarkers in different patient groups. A systematic literature search was conducted on the databases PubMed and Embase to identify all original articles that investigated inflammatory biomarkers in patients receiving TXA and compared them to a relevant control group. The review was performed according to the PRISMA guidelines, and the literature search was performed on November 29, 2021. Thirty-three studies were included, among which 14 studies compared patients receiving TXA with patients getting no medication, another 14 studies investigated different dosing regimens of TXA, and finally five studies examined the administration form of TXA. The present review suggests that TXA has an anti-inflammatory effect in patients undergoing orthopaedic surgery illustrated by decreased levels of C-reactive protein and interleukin-6 in patients receiving TXA compared with patients receiving no or lower doses of TXA. However, the anti-inflammatory effect was not found in patients undergoing cardiac surgery, pediatric craniosynostosis patients, or in rheumatoid arthritis patients. The inflammatory response was not affected by administration form of TXA (oral, intravenous, or topical). In conclusion, an anti-inflammatory effect of TXA was consistently found among orthopaedic patients only.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Tranexamic Acid and Its Potential Anti-Inflammatory Effect: A Systematic Review

Okholm

Krog

Hvas

2022

Semin Thromb Hemost

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“…Of the reviewed studies, fifteen assessed the use of TXA in craniofacial surgery procedures [29][30][31][32][33][34][35][36][37][38][39][40][41][42][43]. Of these, nine were retrospective cohort studies [29-31, 34, 35, 38-40, 42], and six were randomized controlled clinical trials [32,33,36,37,41,43]. Study sample ranged from 25 to 187 patients, apart from a single retrospective cohort study of 1638 patients.…”

Section: Craniofacial Surgerymentioning

confidence: 99%

“…Eight studies reported a notable decline in transfusion requirements, owing to decreased intraoperative bleeding, ranging from 19 to 85% [28,[31][32][33][34][37][38][39]. Other notable outcomes included a clearer surgical field [36], shorter length of hospital stay [40], lower drop in postoperative hemoglobin level, higher postoperative estimated red cell volume [30], and decreased surgical drain Fig.…”

Section: Craniofacial Surgerymentioning

confidence: 99%

Tranexamic acid in plastic surgery: routes of administration and dosage considerations

et al. 2021

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Background Excessive blood loss, during or after surgery, remains a major surgical concern despite the continuous improvement of surgical standards. Tranexamic acid (TXA), an anti-fibrinolytic, is a potential agent that has been used in a variety of methods to mitigate blood loss. In addition, TXA shows additional anti-inflammatory effects which may be of particular interest. The objective of this study is to review clinical studies involving the use of TXA in plastic surgery related procedures. Methods We carried out a literature search of Google Scholar, PubMed, Ovid Medline, and Cochrane databases since their inception for relevant clinical studies on TXA use (dosages/routes of administration) in plastic surgery-related procedures. Results Forty-five articles were included in this review. These included studies assessing the use of TXA in craniofacial surgery (15 studies), aesthetic and breast-related surgeries (23 studies), burn care (4 studies), and microsurgery (3 studies). For each subset, study design, study sample size, surgical procedure performed, TXA route of administration, dosage, study outcomes, and adverse events were summarized and reported in a separate section. Conclusions TXA is widely studied in the field of craniofacial surgery, specifically craniosynostosis surgery. Intravenous administration of TXA is the most commonly studied route of administration. Topical formulations seem to be on the rise and the added local anti-inflammatory effects and safety profile of topical use add significant appeal. Moreover, evidence on appropriate dosage protocols is scarce. The variable approach in dosing warrants further trials to assess the clinical implications, as well as potential benefit in using TXA more efficiently in the field of plastic surgery, as a whole. Level of evidence: Not ratable

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Hämostase

Miesbach¹,

Schöchl²

2023

Die Intensivmedizin

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Effect of tranexamic acid on markers of inflammation in children undergoing craniofacial surgery

Cited by 4 publications

References 22 publications

Tranexamic Acid and Its Potential Anti-Inflammatory Effect: A Systematic Review

Tranexamic Acid and Its Potential Anti-Inflammatory Effect: A Systematic Review

Tranexamic acid in plastic surgery: routes of administration and dosage considerations

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