Tranexamic acid in burn surgery: A systematic review and meta-analysis

Fijany, Arman J.; Givechian, Kevin B.; Zago, Ilana; Olsson, Sofia E.; Boctor, Michael J.; Gandhi, Rajesh R.; Pekarev, Maxim

doi:10.1016/j.burns.2023.05.009

Cited by 6 publications

(4 citation statements)

References 54 publications

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“…Recently, Fijany et al [ 16 ] published a systematic review and meta-analysis considering the effectiveness of tranexamic acid in burn surgery patients. Conclusions were in contrast with conclusions from this current study.…”

Section: Discussionmentioning

confidence: 99%

“…Conclusions were in contrast with conclusions from this current study. According to Fijany et al overall blood loss significantly reduced in tranexamic acid groups from the random-effects model [ 16 ]. However, data from RCT’s and non-RCT’s were pooled in the meta-analysis.…”

Section: Discussionmentioning

confidence: 99%

“…The results indicated that tranexamic acid reduced the intraoperative blood loss significantly. Although Fijany et al recently published a review and meta-analysis which included above-mentioned studies [ 16 ]. The authors pooled results from RCTs with a non-randomised cohort study in the meta-analysis [ 16 ].…”

Section: Introductionmentioning

confidence: 99%

“…Although Fijany et al recently published a review and meta-analysis which included above-mentioned studies [ 16 ]. The authors pooled results from RCTs with a non-randomised cohort study in the meta-analysis [ 16 ]. This decision can be debated as the level of evidence of these two designs differ and thus should not be combined.…”

Section: Introductionmentioning

confidence: 99%

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Effectiveness of tranexamic acid in burn patients undergoing surgery – a systematic review and meta-analysis

Slob,

Gigengack,

van Baar

et al. 2024

BMC Anesthesiol

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Summary Background Reducing blood loss during excisional surgery in burn patients remains a challenge. Tranexamic acid during surgery can potentially reduce blood loss. The use of tranexamic acid during excisional surgery in burn patients has recently been described in a review and meta-analysis. However, quality assessment on studies included was not performed and this review did not apply independent reviewers. Quality assessment of studies investigating the effectiveness of tranexamic acid in burn patients is crucial before concusions can be drawn. Therefore, we conducted a systematic review and meta-analysis of the literature investigating the effectiveness of tranexamic acid in burn patients undergoing surgery. Methods A systematic review and meta-analysis of the literature was conducted. The study was pre-registered in PROSPERO database (CRD42023396183). Results Five studies including two randomised controlled trials (RCTs) with a total of 303 patients were included. Risk of bias of the included studies was moderate to high. Individual results of the studies were heterogeneous. In three studies of moderate quality the administration of tranexamic acid resulted in a reduction of blood loss per unit excised area, accounting as moderate level of evidence. In two low-quality studies and one moderate quality study the administration of tranexamic acid resulted in a reduction of transfused packed Red Blood Cells (pRBC’s), accounting for moderate level of evidence. Postoperative haemoglobin levels were higher after tranexamic acid administration in one study, accounting for insufficient evidence. Meta-analysis pooling overall blood loss from two separate RCTs failed to detect a statistically significant reduction. Substantial heterogeneity was observed. Conclusions Moderate level of evidence indicates that tranexamic acid reduces blood loss per unit of excised area and transfusion of packed Red Blood Cells. Results indicate that tranexamic acid can be beneficial in burn patients undergoing surgery. More high-quality research is needed to confirm these results. Future studies should focus on the dosing of tranexamic acid, the administration approaches, and even consider combining these approaches. Trial Registration PROSPERO: CRD42023396183

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%