The efficacy of intravenous aminocaproic acid in primary total hip and knee arthroplasty: a meta-analysis

Li, Yongjiang; Xu, Bisheng; Bai, Sunpeng; Guo, Xiao-jun; Xiang-yuan, Yan

doi:10.1186/s13018-018-0802-5

Cited by 7 publications

(8 citation statements)

References 16 publications

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“…Antifibrinolytic agents have been tested for their functions of reducing the blood loss during various surgery [6][7][8]. Tranexamic acid (TXA) and epsilon-aminocaproic acid (EACA) are two such antifibrinolytic agents.…”

Section: Introductionmentioning

confidence: 99%

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Local administration of epsilon-aminocaproic acid reduces post-operative blood loss from surgery for closed, Sanders III–IV calcaneal fractures

Zhong

Wang

et al. 2022

International Orthopaedics (SICOT)

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Purpose To investigate whether local administration of epsilon-aminocaproic acid (EACA) is effective and safe in reducing the post-operative blood loss in surgery for Sanders III–IV calcaneal fractures. Methods Patients with Sanders III–IV calcaneal fractures who were hospitalized in our hospital from January 2016 to February 2021 and underwent open reduction internal fixation (ORIF) via lateral approach with an L-shaped incision were included in the current study. Eighty five patients were randomly divided into two groups, EACA group (43) and control group (42). Twenty milliliters of 5% EACA solution or normal saline was perfused into the incision of patients in EACA group and control group, respectively. The volume of post-operative drainage was investigated as the primary outcome. Post-operative blood test, coagulation test, and wound complications were analyzed as the secondary outcomes. Results The volume of post-operative drainage at 24 and 48 h was 164.8 ± 51.4 ml, 18.9 ± 3.8 ml for patients in EACA group, and 373.0 ± 88.1 ml, 21.2 ± 4.4 ml for patients in the control group, respectively. EACA greatly reduced the post-operative blood loss compared to the control (normal saline). The difference between the two groups was statistically significant. No statistically significant difference was found between EACA group and control group with regard to the pre-operative, baseline characteristics. Post-operative blood test results demonstrated that haemoglobin and hematocrit were significantly higher in EACA compared to those of control group. No significant difference was found between EACA group and control group in terms of the platelet counts, prothrombin time (P.T.), activated partial prothrombin time (APTT), and wound complications. Conclusion Local administration of EACA is effective in post-operative blood loss reduction in ORIF surgeries for Sanders III–IV types of calcaneal fractures without increasing the incidence of periwound complication.

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Section: Introductionmentioning

confidence: 99%

“…EACA is another widely used antifibrinolytic agent to prevent or reduce bleeding in various procedures [ 11 ], such as total knee arthroplasty [ 7 ]. Not surprisingly, systematic application of EACA has also been reported to be associated with, though rare, various complications [ 11 ].…”

Section: Introductionmentioning

confidence: 99%

Local administration of epsilon-aminocaproic acid reduces post-operative blood loss from surgery for closed, Sanders III–IV calcaneal fractures

Zhong

Wang

et al. 2022

International Orthopaedics (SICOT)

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“…Several clinical studies have shown that aminocaproic acid effectively reduces HBL during the perioperative period following total knee and total hip arthroplasty. 12,13 To the best of our knowledge, only a few studies so far have examined the role of aminocaproic acid in reducing perioperative HBL in femoral intertrochanteric fractures. Therefore, we conducted a prospective randomised controlled trial to determine the efficacy of aminocaproic acid in decreasing HBL in elderly patients with femoral intertrochanteric fractures undergoing the PFNA procedure.…”

Section: Introductionmentioning

confidence: 99%

Effects of aminocaproic acid on perioperative hidden blood loss in elderly patients with femoral intertrochanteric fracture treated with proximal femoral nail anti-rotation

et al. 2019

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ObjectiveTo determine the efficacy of aminocaproic acid on perioperative hidden blood loss (HBL) in elderly patients with femoral intertrochanteric fracture treated with proximal femoral nail anti-rotation (PFNA).MethodsSeventy consecutively admitted elderly patients with femoral intertrochanteric fracture treated with PFNA between 1 May 2017 and 1 May 2018 were recruited. The patients were randomised into the experimental and control groups receiving 1 g aminocaproic acid in 200 mL saline and only 200 mL normal saline intravenously, respectively. The following factors were recorded: demographic characteristics, haemoglobin and haematocrit levels on preoperative day 1 and postoperative days 1 and 3, surgical blood loss, postoperative drainage, the rate and volume of transfusion, and complications.ResultsNo significant differences were seen in surgical blood loss and postoperative drainage between the experimental and control groups, though total blood loss was greater in the control group. Visible blood loss and HBL were significantly lower in the experimental group than in the control group, and a lower rate and volume of transfusion were also recorded in the experimental group.ConclusionAminocaproic acid significantly reduced perioperative HBL and volume and rate of transfusion in elderly patients with femoral intertrochanteric fracture receiving PFNA.

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“…Thus, blood management after THA is an important issue. Many kinds of techniques, including autologous fibrin tissue and aminocaproic acid, have been used to decrease bleeding and blood transfusion requirements after major orthopaedic surgery. Tranexamic acid (TXA) is a medication used to treat or prevent excessive blood loss from major trauma, postpartum bleeding, and surgery.…”

Section: Introductionmentioning

confidence: 99%

Does Aprotinin Reduce the Blood Loss after Total Hip Arthroplasty? A Meta‐analysis of Randomized Controlled Trials

2019

Orthopaedic Surgery

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We perform a meta‐analysis from published randomized controlled trials to assess the efficacy and safety of aprotinin in total hip arthroplasty (THA). The following electronic databases were searched: PubMed (1966 to December 2018), EMBASE (1974 to December 2018), the Cochrane Library (1974 to December 2018), and Web of Science (1990 to December 2018). We also used Google Search to search for more potentially eligible studies up to December 2018. The methodological quality of the included studies was assessed independently by the two reviewers described by the Cochrane Collaboration for Systematic Reviews. Data analysis was performed with STATA13.0. Four randomized controlled trials were included in the meta‐analysis. Our study indicated that intravenous aprotinin was associated with improved outcomes in terms of total blood loss, hemoglobin decline, and transfusion rates. There was no significant difference regarding the length of stay and the risk of deep venous thrombosis and pulmonary embolism. Intravenous aprotinin was effective and safe to use in reducing total blood loss after total hip arthroplasty. Further high‐quality studies are required to confirm the conclusion.

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The efficacy of intravenous aminocaproic acid in primary total hip and knee arthroplasty: a meta-analysis

Cited by 7 publications

References 16 publications

Local administration of epsilon-aminocaproic acid reduces post-operative blood loss from surgery for closed, Sanders III–IV calcaneal fractures

Local administration of epsilon-aminocaproic acid reduces post-operative blood loss from surgery for closed, Sanders III–IV calcaneal fractures

Effects of aminocaproic acid on perioperative hidden blood loss in elderly patients with femoral intertrochanteric fracture treated with proximal femoral nail anti-rotation

Does Aprotinin Reduce the Blood Loss after Total Hip Arthroplasty? A Meta‐analysis of Randomized Controlled Trials

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