The Dose-Response Relationship of Tranexamic Acid

Horrow, Jan C.; Riper, Daniel F. Van; Strong, Michael D.; Grunewald, Karl; Parmet, Jonathan L.

doi:10.1097/00132586-199602000-00010

Cited by 72 publications

(101 citation statements)

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“…Long-term follow-up data on these patients was not available, however, the remote thromboembolism secondary to intraoperative single dose of tranexamic acid seems unlikely as it has a short halflife (14) . This observation is in accordance with other controlled studies; including several randomised studies in patients undergoing cardiac surgery (43)(44)(45)(46) . Furthermore, no thromboembolic episode was reported in a retrospective analysis of 256 pregnant women with bleeding disorders who were on tranexamic acid (47) .…”

Section: Surgical Field Qualitysupporting

confidence: 92%

Role of tranexamic acid in endoscopic sinus surgery - A systematic review and meta-analysis

Pundir¹,

Pundir²,

Georgalas

et al. 2013

Rhin

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SummaryBackground: The role of tranexamic acid in patients undergoing endoscopic sinus surgery (ESS) is not clearly defined. The aim of our study is to systematically review the existing evidence on the role of tranexamic acid in patients undergoing ESS.Methodology: Systematic search of MEDLINE (1950MEDLINE ( -2013, EMBASE (1980EMBASE ( -2013, metaRegister, Cochrane Library and ISI conference proceedings was carried out. Results:Five randomised controlled trials with 192 patients receiving tranexamic acid and 196 controls were included. Metaanalysis demonstrated that mean estimated blood loss was significantly lower, and surgical field quality was significantly better in tranexamic acid group. There was no significant difference in mean operative time between the two groups. No significant adverse effects were noted in either of the groups. Conclusion:Intra-operative use of local and systemic tranexamic acid in ESS, results in significantly reduced estimated blood loss and improved surgical field quality. There is no statistically significant difference seen in operative time and incidence of side effects. Well-conducted larger RCTs using validated objective outcome measures and reporting on minor and major complications are required.

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Section: Surgical Field Qualitysupporting

confidence: 92%

Role of tranexamic acid in endoscopic sinus surgery - A systematic review and meta-analysis

Pundir¹,

Pundir²,

Georgalas

et al. 2013

Rhin

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“…Therapeutic plasma concentrations of TA (5-10 mg·L -1 ) can be achieved with a bolus of 10 mg·kg -1 iv followed by an infusion of 1 mg·kg -1 ·hr -1 . 9 Numerous studies have confirmed the efficacy of TA to reduce blood losses and transfusion requirements in total knee replacement (TKR). [10][11][12][13][14][15][16] The aim of this study was to assess the efficacy of TA to reduce blood losses and blood transfusion requirements in patients undergoing THR.…”

Section: Conclusion : L'at Ne Réduit Pas Les Pertes Sanguines Mesuréementioning

confidence: 99%

Tranexamic acid reduces the need for allogenic red blood cell transfusions in patients undergoing total hip replacement

Lemay

Guay

Côté

et al. 2004

Can J Anesth/J Can Anesth

112

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“…As doses variam de 150 mg.kg -1 em dose única, até 10 mg.kg -1 , como dose inicial, seguida de infusão de 1 mg.kg -1 .h -1 . O maior estudo prospectivo e duplamente encoberto que comparou cinco doses diferentes realizado por Horrow e col. 63 , demonstrou que a dose inicial de 10 mg.kg -1 , seguida da infusão de 1 mg.kg. -1 h -1 , é a mais adequada.…”

Section: áCido Tranexâmicounclassified

“…The doses vary between a single dose of 150 mg.kg -1 to an initial dose of up to 10 mg.kg -1 followed by the infusion of 1 mg.kg -1 .h -1 . The larger prospective, doubleblind study that compared 5 different doses, undertaken by Horrow et al 63 , demonstrated that an initial dose of 10 mg.kg -1 followed by the infusion of 1 mg.kg -1 .h -1 , is the most adequate. This dose provides serum levels above 10 µg.ml -1 , enough to suppress fibrinolytic activity 64 .…”

Section: Tranexamic Acidmentioning

confidence: 99%

Antifibrinolíticos e cirurgia cardíaca com circulação extracorpórea

Santos¹,

Splettstosser²,

Warpechowski³

et al. 2007

Rev. Bras. Anestesiol.

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RESUMOSantos ATL, Splettstosser JC, Warpechowski P, Gaidzinski MMPAntifibrinolíticos e Cirurgia Cardíaca com Circulação Extracorpórea. JUSTIFICATIVA E OBJETIVOS:A cirurgia cardíaca é a especialidade cirúrgica que com mais freqüência está associada a sangramento, coagulopatia e necessidade de derivados de sangue. Os agentes farmacológicos aprotinina, ácido epsilon-aminocapróico e ácido tranexâmico são os mais utilizados para auxiliar na hemostasia dos pacientes submetidos à circulação extracorpórea. O objetivo deste trabalho foi apresentar a fisiopatologia do sangramento em cirurgia cardíaca e a atual situação dos antifibrinolíticos quanto à sua eficácia e complicações quando usados nesses procedimentos, dando maior ênfase ao ácido tranexâmico e à aprotinina. CONTEÚDO:São discutidos os mecanismos pelos quais a circulação extracorpórea provoca alteração na hemostasia e de que maneira os antifibrinolíticos agem para diminuir o sangramento e o uso de sangue alogênico em cirurgia cardíaca. É dada ênfase ao problema do tromboembolismo que pode ocorrer com o emprego desses antifibrinolíticos, com revisão da literatura. CONCLUSÃO:A fibrinólise é um dos principais fatores relacionados com o aumento do sangramento em cirurgia cardíaca com circulação extracorpórea. A inibição da fibrinólise, juntamente com a preservação da função plaquetária, é, provavelmente, o mecanismo pelo qual os antifibrinolíticos diminuem o sangramento. O emprego desses fármacos reduz o sangramento em cirurgia cardíaca com circulação extracorpórea num percentual que pode chegar a 50%. Com relação à preocupação com o tromboembolismo, os áci-dos tranexâmico e epsilon-aminocapróico são opções que oferecem maior segurança que a aprotinina.Unitermos: CIRURGIA, Cardíaca: circulação extracorpórea, DRO-GAS, Antifibrinolíticos: aprotinina, ácido epsilon-aminocapróico, áci-do tranexâmico; SANGUE: coagulação. SUMMARYSantos ATL, Splettstosser JC, Warpechowski P, Gaidzinski MMPAntifibrinolytics and Cardiac Surgery with Cardiopulmonary Bypass. BACKGROUND AND OBJECTIVES:Cardiac surgery is the surgical subspecialty most often associated with bleeding, bleeding disorders, and the need of blood products. Agents such as aprotinin, episilon-aminocaproic acid, and tranexamic acid are frequently used to aid the hemostasis of patients undergoing cardiopulmonary bypass. The objective of this report is to present the physiopathology of bleeding during cardiac surgeries and the current role of antifibrinolytics regarding their efficacy and complications when used in those procedures, with emphasis on tranexamic acid and aprotinin. CONTENTS:The mechanisms of changes in hemostasis caused by cardiopulmonary bypass, how antifibrinolytics decrease bleeding, and the use of alogenic blood in cardiac surgery are discussed. A review of the literature emphasizes the thromboembolism secondary to the use of those antifibrinolytics. CONCLUSION:Fibrinolysis is one of the main factors related with increased bleeding during cardiac surgery with cardiopulmonary bypass. Inhibition of fibrinol...

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The Dose-Response Relationship of Tranexamic Acid

Cited by 72 publications

References 0 publications

Role of tranexamic acid in endoscopic sinus surgery - A systematic review and meta-analysis

Role of tranexamic acid in endoscopic sinus surgery - A systematic review and meta-analysis

Tranexamic acid reduces the need for allogenic red blood cell transfusions in patients undergoing total hip replacement

Antifibrinolíticos e cirurgia cardíaca com circulação extracorpórea

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