Hemostatic changes and postoperative deep-vein thrombosis associated with use of a pneumatic tourniquet.

Fahmy, N R; Patel, Dwijal

doi:10.2106/00004623-198163030-00023

Cited by 132 publications

(56 citation statements)

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“…The loss of hemoglobin then was estimated according to the following formula [11,18]: Hb loss = patient's blood volume * (Hb i À Hb e ) * 0.001 + Hb t , where Hb loss (grams) was the amount of hemoglobin lost up to Day 5 after surgery, Hb i (grams/liter) was the hemoglobin concentration before surgery, Hb e (grams/liter) was the hemoglobin concentration on the fifth day after surgery, and Hb t (grams) was the amount of hemoglobin transfused. From these, the total blood loss in milliliters was calculated as follows [12,19]: total blood loss = 1000 * Hb loss /Hb i .…”

Section: Methodsmentioning

confidence: 99%

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Most Effective Regimen of Tranexamic Acid in Knee Arthroplasty: A Prospective Randomized Controlled Study in 240 Patients

Maniar

Kumar²,

Singhi

et al. 2012

Clinical Orthopaedics &Amp; Related Research

277

256

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Background The antifibrinolytic tranexamic acid reduces surgical blood loss, but studies have not identified an optimal regimen. Questions/purposes We studied different dosages, timings, and modes of administration to identify the most effective regimen of tranexamic acid in achieving maximum reduction of blood loss in TKA. Methods We prospectively studied five regimens (four intravenous, one local; 40 patients each) with a control group (no tranexamic acid). The four intravenous (10-mg/kg dose) regimens included (1) intraoperative dose (IO) given before tourniquet deflation, (2) additional preoperative dose (POIO), (3) additional postoperative dose (IOPO), and (4) all three doses (POIOPO). The fifth regimen was a single local application (LA). Two independent parameters of drain loss and total blood loss, calculated by the hemoglobin balance method, were evaluated statistically. Results Both parameters were reduced in all five regimens as against the control. A significant reduction in drain loss was seen in the POIO, IOPO, and POIOPO groups whereas total blood loss was significantly reduced in the POIO, POIOPO, and LA groups. The POIOPO group had the least drain loss (303 mL) and least total blood loss (688 mL). The IO group had the greatest drain loss and the IOPO group the greatest total blood loss. Conclusions Single-dose tranexamic acid did not give effective results. The two-dose regimen of POIO was the least amount necessary for effective results. When compared against the control, this regimen produced reduction of drain loss and total blood loss, whereas the IOPO regimen did not. The three-dose regimen of POIOPO produced maximum effective reduction of drain loss and total blood loss.

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Section: Methodsmentioning

confidence: 99%

“…Estimated blood loss reported for TKA varies between 800 mL to 1800 mL [2,7,13,20,27], mostly related to surgical trauma. Trauma also induces fibrinolysis [2,3,16,26], which in TKA is enhanced by the use of a pneumatic tourniquet [11,17,24,26]. This further contributes to bleeding during and after surgery [5].…”

Section: Introductionmentioning

confidence: 99%

Most Effective Regimen of Tranexamic Acid in Knee Arthroplasty: A Prospective Randomized Controlled Study in 240 Patients

Maniar

Kumar²,

Singhi

et al. 2012

Clinical Orthopaedics &Amp; Related Research

277

256

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“…The fibrinolytic system is activated transiently after any surgery [30], and the use of a pneumatic tourniquet to create a bloodless field is associated with increased fibrinolytic activity in the surgically treated limb in animal models [23] and for patients having elective orthopaedic surgery [10,29]. The increased fibrinolytic activity may increase blood loss after knee arthroplasty during first few postoperative hours [5,13].…”

Section: Introductionmentioning

confidence: 99%

Does Tranexamic Acid Save Blood in Minimally Invasive Total Knee Arthroplasty?

Lin

Hsu

Chen

et al. 2011

Clinical Orthopaedics &Amp; Related Research

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“…Previous reports on tranexamic acid in joint replacement surgery have demonstrated that tranexamic acid reduces postoperative, but not perioperative, bleeding [2,3,11]. As for total knee arthroplasty (TKA), the use of a tourniquet induces local fibrinolysis in the operative limb [10], and increased fibrinolytic activity may increase bleeding after surgery [13,18]. In total hip arthroplasty (THA) fibrinolysis is similarly induced by surgical trauma [7].…”

Section: Introductionmentioning

confidence: 99%

Tranexamic acid reduces blood loss after cementless total hip arthroplasty?prospective randomized study in 40 cases

Yamasaki¹,

Masuhara²,

Fuji³

2004

International Orthopaedics

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Hemostatic changes and postoperative deep-vein thrombosis associated with use of a pneumatic tourniquet.

Cited by 132 publications

References 0 publications

Most Effective Regimen of Tranexamic Acid in Knee Arthroplasty: A Prospective Randomized Controlled Study in 240 Patients

Most Effective Regimen of Tranexamic Acid in Knee Arthroplasty: A Prospective Randomized Controlled Study in 240 Patients

Does Tranexamic Acid Save Blood in Minimally Invasive Total Knee Arthroplasty?

Tranexamic acid reduces blood loss after cementless total hip arthroplasty?prospective randomized study in 40 cases

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