Enterale Resorption, Verteilung und Elimination von 4-Aminomethylcyclohexancarbons�ure (AMCHA) und ?-Aminocaprons�ure (ACS) beim Menschen

Kaller, H

doi:10.1007/bf00539612

Cited by 17 publications

(6 citation statements)

References 9 publications

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“…Previously, many studies have shown that the intravenous administration of tranexamic acid can lead to significant reduction in drain output, haemoglobin loss and blood transfusion requirements [3, 4, 7, 12–15, 29, 33, 36]. Since the maximum therapeutic effect of a single intravenous dose of tranexamic acid persists for about 3 h [16], frequent dosing is required. This, in turn, may have cumulative effect thereby complicating the post‐operative treatment protocol.…”

Section: Introductionmentioning

confidence: 99%

Efficacy of intra-articular tranexamic acid in blood loss reduction following primary unilateral total knee arthroplasty

Roy

Tanki

Dutta

et al. 2012

Knee Surg Sports Traumatol Arthrosc

105

108

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Purpose The surgical stress of total knee arthroplasty (TKA) procedure and the application of intra‐operative pneumatic thigh tourniquet increases local fibrinolytic activity, which contributes significantly to post‐operative blood loss. Tranexamic acid, an antifibrinolytic drug, is commonly used to control post‐operative blood loss. The recommended mode of administration of tranexamic acid is either oral or intravenous. However, the mechanism of action of the tranexamic acid points towards the possible effectiveness it may have following local/intra‐articular application. This prospective, double‐blinded, randomized preliminary study evaluated the efficacy of intra‐articular tranexamic acid in reducing TKA‐associated post‐operative blood loss. Methods Fifty consenting patients with osteoarthritis of the knee scheduled for primary unilateral cemented‐TKA were randomly allocated to one of the two groups: Tranexamic Acid (TA) group (n = 25, 500 mg/5 ml tranexamic acid) and the control group (n = 25, 5 ml 0.9% saline). The drug and control solution were administered intra‐articularly through the drain tube immediately after the wound closure. Parameters related to blood loss (drop in haemoglobin, haematocrit differential) and the drain output [volume (ml)] were compared between the two groups. Results On a comparative basis, TA‐group obtained significant reduction in the drain output [95% CI: 360.41–539.59, p < 0.001] at 48 h post‐operatively. Even though the control group received sixfold more blood transfusion than TA‐group, it showed a greater drop in haemoglobin and haematocrit (p < 0.05). Conclusions Local application of tranexamic acid seems to be effective in reducing post‐TKA blood loss as well as blood transfusion requirements. Level of evidence Therapeutic study, Level II.

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Section: Introductionmentioning

confidence: 99%

Efficacy of intra-articular tranexamic acid in blood loss reduction following primary unilateral total knee arthroplasty

Roy

Tanki

Dutta

et al. 2012

Knee Surg Sports Traumatol Arthrosc

105

108

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“…17 An i.v. dose of tranexamic acid 10 mg kg -1 maintains such plasma concentration for only 3 h. 18 This may be insufficient to prevent postoperative bleeding in prosthetic knee surgery and thus is an argument for using higher doses. Furthermore, there are indications that local enhancement of fibrinolysis elicited by application of a tourniquet may affect haemostasis for a considerably longer time than the surgical procedure.…”

mentioning

confidence: 99%

Use of tranexamic acid for an effective blood conservation strategy after total knee arthroplasty

Jansen¹,

Andreica²,

Claeys³

et al. 1999

British Journal of Anaesthesia

197

154

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We have investigated the effect of treatment with tranexamic acid, an inhibitor of fibrinolysis, on blood loss, blood transfusion requirements and blood coagulation in a randomized, double-blind, placebo-controlled study of 42 patients after total knee arthroplasty. Tranexamic acid 15 mg kg-1 (n = 21) or an equivalent volume of normal saline (n = 21) was given 30 min before surgery and subsequently every 8 h for 3 days. Coagulation and fibrinolysis values, blood loss and blood units administered were measured before administration of tranexamic acid, 8 h after the end of surgery and at 24 and 72 h after operation. Coagulation profile was examined (bleeding time, platelet count, prothrombin time (PT), activated partial thromboplastin time (aPTT), plasminogen, beta-thromboglobulin and fibrinogen). Fibrinolysis was evaluated by measurement of concentrations of D-dimer and fibrinogen degradation products (FDP). Total blood loss in the tranexamic acid group was 678 (SD 352) ml compared with 1419 (607) ml in the control group (P < 0.001), and occurred primarily during the first 24 h after surgery. Thirteen patients received 1-5 u. of packed red blood cells in the control group compared with two patients in the tranexamic acid group, who received 3 u. (P < 0.001). Postoperative packed cell volume values were higher in the tranexamic acid group despite fewer blood transfusions. Postoperative concentrations of plasminogen were decreased significantly in the tranexamic acid group (P < 0.001). Platelet count, PT, aPTT, bleeding time, beta-thromboglobulin, fibrinogen and FDP concentrations did not differ between groups, but D-dimer concentrations were increased in the control group. Thromboembolic complications occurred in two patients in the control group compared with none in the tranexamic acid group.

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“…Judging from in-vitro experiments and clinical experience control of systemic fibrinolysis requires a plasma AMCA concentration of about [10][11][12][13][14][15] ,ug/ml. Since the drug is rapidly excreted in the urine it must, like EACA, be given intravenously at short intervals to maintain a therapeutic level.…”

mentioning

confidence: 99%

Clinical pharmacology of aminocaproic and tranexamic acids

Nilsson¹

1980

Journal of Clinical Pathology

102

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Enterale Resorption, Verteilung und Elimination von 4-Aminomethylcyclohexancarbons�ure (AMCHA) und ?-Aminocaprons�ure (ACS) beim Menschen

Cited by 17 publications

References 9 publications

Efficacy of intra-articular tranexamic acid in blood loss reduction following primary unilateral total knee arthroplasty

Efficacy of intra-articular tranexamic acid in blood loss reduction following primary unilateral total knee arthroplasty

Use of tranexamic acid for an effective blood conservation strategy after total knee arthroplasty

Clinical pharmacology of aminocaproic and tranexamic acids

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