The Effect of Tranexamic Acid and Gender on Intraoperative Bleeding in Orthognathic Surgery—A Randomized Controlled Trial

Secher, Jesper Jared; Sidelmann, Johannes Jakobsen; Ingerslev, Janne; Thorn, Jens Jørgen; Pinholt, Else Marie

doi:10.1016/j.joms.2017.11.015

Cited by 25 publications

(22 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Interestingly, TXA administration has only recently been associated with sex differences. A 2018 clinical trial showed that TXA effectively reduced blood loss in female but not male patients undergoing bimaxillary orthognathic surgery 32 . While our findings contrast these data, it is possible that our findings may be specific to TBI or that other factors (eg, menopause, birth control) could have influenced the outcomes of the surgery clinical trial 32 .…”

Section: Discussioncontrasting

confidence: 79%

“…In this study, we investigated the effect of TXA on BBB integrity after TBI and further aimed to address the relationship between plasmin and the acute immune response to brain injury. Given that sex differences in TBI studies are more frequently reported, 31 and that the utilization of TXA in orthognathic surgery 32 and skin care 33 have recently revealed sex‐specific effects, this led us to evaluate the effect of TXA in TBI in mice of both sexes. Plasminogen‐deficient mice (plg −/− ) were also utilized to further address the role of the PA system in TBI.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Sex‐dependent effects of tranexamic acid on blood‐brain barrier permeability and the immune response following traumatic brain injury in mice

Daglas

Galle

Draxler

et al. 2020

Journal of Thrombosis and Haemostasis

View full text Add to dashboard Cite

Background: Tranexamic acid (TXA) is an anti-fibrinolytic agent used to reduce bleeding in various conditions including traumatic brain injury (TBI). As the fibrinolytic system also influences the central nervous system and the immune response, TXA may also modulate these parameters following TBI. Objectives: To determine the effect of TXA on blood-brain barrier (BBB) integrity and changes in immune and motor function in male and female mice subjected to TBI. Methods: Wild-type and plasminogen deficient (plg−/−) mice were subjected to TBI then administered either TXA/vehicle. The degree of BBB breakdown, intracerebral hemorrhage (ICH), motor dysfunction, and changes in inflammatory subsets in blood and brain were determined. Results and conclusions: Tranexamic acid significantly reduced BBB breakdown, and increased blood neutrophils in male mice 3 hours post-TBI. In contrast, TXA treatment of female mice increased BBB permeability and ICH but had no effect on blood neutrophils at the same time-point. TXA improved motor function in male mice but still increased BBB breakdown in female mice 24 hours post-TBI. Brain urokinase-type plasminogen activator (u-PA) antigen and activity levels were significantly higher in injured females compared to males. Because TXA can promote a pro-fibrinolytic effect via u-PA, these sex differences may be related to brain u-PA levels. TXA also increased monocyte subsets and dendritic cells in the injured brain of wild-type male mice 1 week post-TBI. Plg −/− mice of both sexes had reduced BBB damage and were protected from TBI irrespective of treatment indicating that TXA modulation of the BBB is plasmin-dependent. In conclusion, TXA is protective post-TBI but only in male mice. K E Y W O R D S blood-brain barrier, fibrinolysis, intracerebral hemorrhage, tranexamic acid, traumatic brain injury | 2659 DAGLAS et AL.

show abstract

Section: Discussioncontrasting

confidence: 79%

Section: Introductionmentioning

confidence: 99%

Sex‐dependent effects of tranexamic acid on blood‐brain barrier permeability and the immune response following traumatic brain injury in mice

Daglas

Galle

Draxler

et al. 2020

Journal of Thrombosis and Haemostasis

View full text Add to dashboard Cite

show abstract

“…Secher et al found a hemostatic effect of TXA in women and none in men who underwent bimaxillary orthognathic surgery. 17 Rajesparan et al found that in total hip replacement, the reduction in blood loss after a single dose of 1g of intravenous TXA was more pronounced in women than in men. 18 Our results are consistent with these findings: the administration of TXA reduced the perioperative blood loss in women and had no such effect in men.…”

Section: Discussionmentioning

confidence: 99%

Impact of age, gender and body mass index on the efficacy of tranexamic acid in total knee arthroplasty

Viegas

Kumar

Carvalho³

et al. 2020

Int J Res Orthop

View full text Add to dashboard Cite

Background: Tranexamic acid (TXA) is effective and safe in decreasing blood loss and transfusion rate in total knee arthroplasty (TKA). Few studies focused on the role of patients’ characteristics on the efficacy of TXA in TKA. The purpose of this study was to conduct a retrospective analysis to investigate if age, gender and BMI influence the efficacy of TXA in reducing perioperative blood loss in TKA.Methods: We did an observational study including 366 consecutive patients undergoing TKA in Hospital Particular do Algarve between January 2011 and April 2019 which were divided in two groups: intraoperative administration of intravenous TXA (TXA Group) and no administration of TXA (Control Group). The perioperative blood loss between groups and their relation with age, gender and BMI was compared.Results: Of the 366 patients, 225 (61%) received TXA. In both groups, age did not correlate to the blood loss. Women in the TXA group had less perioperative blood loss than in the control group. No such difference was found for men. The normal weight group showed no difference in perioperative blood loss with or without TXA administration. However, there was a statistically significant difference in the overweight and obese groups. The mean perioperative blood loss was higher in the control group (854±342 ml) than in the TXA group (720±335 ml).Conclusions: TXA administration is efficient in controlling TKA associated hemorrhage in overweight and obese individuals and in women but it doesn’t have that effect in normal weight patients or in men.

show abstract

“…Finally, 6 independent studies were included in the final meta-analysis. [9][10][11][12][13][14] The detailed steps of our literature search and the study selection are described in Figure 1.…”

Section: Literature Search and Study Characteristicsmentioning

confidence: 99%

“…However, these studies were of limited sample size, preventing a validation of certain outcomes unless meta-analysis is performed. 2,[9][10][11][12][13][14] On the other hand, currently published meta-analyses included all types of OS and neglected routes of TXA administration. 3,5,15 Accordingly, considering unique role of bimaxillary OS in the clinical settings, we conducted a meta-analysis of randomized controlled trials (RCTs) to comprehensively assess the role of TXA during bimaxillary OS.…”

Section: Introductionmentioning

confidence: 99%

Efficacy and Safety of Tranexamic Acid in Bimaxillary Orthognathic Surgery

2020

View full text Add to dashboard Cite

Background: Tranexamic acid (TXA) has been widely used during craniofacial and orthognathic surgery (OS). However, results of the literature are inconsistent due to specific type of surgery and a small sample of studies. The purpose of this study was to evaluate the role of TXA in bimaxillary OS. Methods: We performed a comprehensive literature search of PubMed, Cochrane Central Register of Controlled Trials, and EMBASE to identify randomized controlled trials (RCTs) that compared effect of TXA on bimaxillary OS with placebo. Outcomes of interests included intraoperative blood loss, allogenic transfusion, operation time, and volume of irrigation fluid. Random effects models were chosen considering that heterogeneity between studies was anticipated, and I 2 statistics were used to test for the presence of heterogeneity. Results: Totally 6 RCTs were identified. Tranexamic acid resulted in significantly reduced intraoperative blood loss (weighted mean difference [WMD] = −264.82 mL; 95% CI: −380.60 to −149.04 mL) and decreased amounts of irrigation fluid (WMD = −229.23 mL; 95% CI: −399.63 to −58.83 mL). However, TXA had no remarkable impact on risk of allogenic blood transfusion (pooled risk ratio = 0.50; 95% CI: 0.20-1.23), operation time (WMD = −8.71 min; 95% CI: −20.98 to 3.57 min), and length of hospital stay (WMD = −0.24 day; 95% CI: −0.62 to 0.14 day). No TXA-associated severe adverse reactions or complications were observed. Conclusions: Currently available meta-analysis reveals that TXA is effective in decreasing intraoperative blood loss; however, it does not reduce the risk of allogenic blood transfusion in bimaxillary OS.

show abstract

The Effect of Tranexamic Acid and Gender on Intraoperative Bleeding in Orthognathic Surgery—A Randomized Controlled Trial

Cited by 25 publications

References 22 publications

Sex‐dependent effects of tranexamic acid on blood‐brain barrier permeability and the immune response following traumatic brain injury in mice

Sex‐dependent effects of tranexamic acid on blood‐brain barrier permeability and the immune response following traumatic brain injury in mice

Impact of age, gender and body mass index on the efficacy of tranexamic acid in total knee arthroplasty

Efficacy and Safety of Tranexamic Acid in Bimaxillary Orthognathic Surgery

Contact Info

Product

Resources

About