Reducing perioperative blood loss with antifibrinolytics and antifibrinolytic-like agents for patients undergoing total hip and total knee arthroplasty

Kapadia, Bhaveen H.; Torre, Barrett; Ullman, Nicholas A.; Yang, Andrew; Harb, Matthew A.; Grieco, Preston W.; Newman, Jared M.; Harwin, Steven F.; Maheshwari, Aditya V.

doi:10.1016/j.jor.2019.06.025

Cited by 15 publications

(16 citation statements)

References 39 publications

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“…This discovery is very important, as one of the molecules used in treatment of patients affected by COVID-19 is chloroquine (CQ), which blocks CME by reducing the expression of the phosphatidylinositol binding clathrin assembly protein (PICALM)[ 82 , 83 ]. Aprotinin, a serine protease inhibitor, is used to treat pancreatitis and to reduce bleeding during surgery[ 84 , 85 ]. Its use was also assessed against influenza viruses, so much so that in Russia a formulation of this molecule in the form of an aerosol has been approved for the treatment of these viruses[ 86 ].…”

Section: Discussionmentioning

confidence: 99%

Paradoxical relationship between proton pump inhibitors and COVID-19: A systematic review and meta-analysis

Zippi¹,

Fiorino²,

Budriesi³

et al. 2021

WJCC

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BACKGROUND The proton pump inhibitors (PPIs), used to reduce gastric acid secretion, represent one of the most widely used pharmaceutical classes in the world. Their consumption as a risk factor for the evolution of severe forms of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has been investigated as well as the mortality of these patients. These risks also appear to be linked to the duration and the dosage. On the other hand, several studies have emerged with regard to the protective or therapeutic effects of these drugs. More and more evidence underlines the immunomodulatory and anti-fibrotic role of PPIs. In addition, their ability to alkalize the contents of endosomes and lysosomes serves as an obstacle to the entry of the virus into the host cells. AIM To identify studies on the relationship between the intake of PPIs and coronavirus disease 2019 (COVID-19) in patients affected by SARS-CoV-2 infection, with the main objective of evaluating the outcomes related to severity and mortality. METHODS A literature review was performed in November 2020. The MEDLINE/PubMed, Cochrane Library, EMBASE and Google Scholar databases were searched for all relevant articles published in English on this topic. The search terms were identified by means of controlled vocabularies, such as the National Library of Medicine’s MESH (Medical Subject Headings) and keywords. The MESH terms and keywords used were as follows: “COVID-19”, “proton pump inhibitors”, ”PPIs”, “SARS-CoV-2”, “outcomes”, “severity” and “mortality”. The inclusion criteria regarding the studies considered in our analysis were: meta-analysis, case-control, hospital-based case-control, population-based case-control, retrospective studies, online survey, as well as cohort-studies, while articles not published as full reports, such as conference abstracts, case reports and editorials were excluded. We tried to summarize and pool all the data if available. RESULTS A total of 9 studies were found that described the use of PPIs, of which only 5 clearly reported the severity and mortality data in SARS-CoV-2 patients. Our pooled incidence analysis of severe events did not differ between patients with and without PPIs (odds ratio 1.65, 95% confidence interval: 0.62-4.35) ( P = 0.314), or for mortality (odds ratio 1.77, 95% confidence interval: 0.62-5.03) ( P = 0.286). CONCLUSION Detailed and larger case studies are needed to accurately understand the role of PPIs in this viral infection.

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Section: Discussionmentioning

confidence: 99%

Paradoxical relationship between proton pump inhibitors and COVID-19: A systematic review and meta-analysis

Zippi¹,

Fiorino²,

Budriesi³

et al. 2021

WJCC

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“…In clinical use Aprotinin is used to reduce blood loss during surgery and for pancreatitis [9,10]. Aprotinin inhibits pro-inflammatory cytokine release and maintains glycoprotein homeostasis.…”

Section: Introductionmentioning

confidence: 99%

Aprotinin - a New Drug Candidate for The Prevention of SARS-CoV-2 (COVID-19)

Ivashchenko¹,

Svistunov

Khorobryh

et al. 2020

Preprint

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“…Fibrin sealant (FS) forms brin that adheres to the wound surface and is formed from human brinogen by the action of thrombin. Previous studies have demonstrated that it can effectively reduce perioperative blood loss, postoperative blood transfusion rate and hemoglobin decline [8][9]. Meanwhile numerous studies have shown that TXA can effectively reduce blood loss and blood transfusion rate during THA [10][11].…”

Section: Introductionmentioning

confidence: 99%

The Efficacy and Safety of Fibrin Sealant Versus Tranexamic Acid Administration in Patients Undergoing Hip Arthroplasty: A Meta-analysis

Yong¹,

Deng²,

Nan³

et al. 2020

Preprint

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PurposeThe efficacy and safety of topical fibrin sealant (FS) compared with tranexamic acid (TXA) to reduce blood loss after total hip arthroplasty (THA) is not clear. A meta-analysis was conducted to evaluate the efficacy and safety of topical FS versus topical or intravenous TXA for treatment of primary THA.MethodWe searched electronic databases, including PubMed, Embase, and the Cochrane Library to identify studies up to March 2020. The references included in articles were also checked for additional potentially-relevant studies. The language of publication was limited to English. The endpoints included the mean difference (MD) of blood loss, hemoglobin value, and odds ratios (ORs) of transfusion requirements and thrombotic events. Our meta-analysis was performed according to the Guidelines of the Cochrane Reviewer's Handbook and the PRISMA statement. The data of the included studies were analyzed using RevMan 5.3.ResultsA total of four studies (two randomized controlled trials and two non-randomized controlled trials) met the inclusion criteria. Our meta-analysis demonstrated that TXA administration led to significantly different outcomes in terms of transfusion rate (RD = -0.12, 95% CI (-0.23, -0.00), P = 0.05, I2 = 74%) and postoperative hemoglobin levels (WMD = -0.47, 95% CI (-0.74, -021), P = 0.0005, I2 = 3%) compared with topical application of FS in patients undergoing THA. No significant difference was seen in total calculated blood loss (WMD = -86.22, 95% CI (-99.13, -73.31), P < 0.00001, I2 = 96%) or complication rate (RR = 0.98, 95% CI (-99.13, -73.31), P = 0.45, I2 = 0%) between the two groups.ConclusionsTXA administration can effectively decrease the transfusion rate and result in higher postoperative hemoglobin levels without increasing the rate of infection.

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Reducing perioperative blood loss with antifibrinolytics and antifibrinolytic-like agents for patients undergoing total hip and total knee arthroplasty

Cited by 15 publications

References 39 publications

Paradoxical relationship between proton pump inhibitors and COVID-19: A systematic review and meta-analysis

Paradoxical relationship between proton pump inhibitors and COVID-19: A systematic review and meta-analysis

Aprotinin - a New Drug Candidate for The Prevention of SARS-CoV-2 (COVID-19)

The Efficacy and Safety of Fibrin Sealant Versus Tranexamic Acid Administration in Patients Undergoing Hip Arthroplasty: A Meta-analysis

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