Tranexamic Acid Reduced the Percent of Total Blood Volume Lost During Adolescent Idiopathic Scoliosis Surgery

Jones, Kristen E.; Butler, Eric; Barrack, Tara; Ledonio, Charles; Forte, Mary; Cohn, Claudia S.; Polly, David W.

doi:10.14444/4027

Cited by 19 publications

(16 citation statements)

References 18 publications

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“…A total of 9 studies were high-dose regimens [ 4 , 5 , 8 – 10 , 15 – 17 , 19 ], and the remaining 8 studies were low-dose regimens [ 7 , 11 – 14 , 18 , 20 , 21 ]. Of these 9 studies, 3 studies were RCTs [ 5 , 8 , 10 ], and the rest were non-RCTs [ 4 , 9 , 15 – 17 , 19 ]. Among these studies with the high-dose regimen, there are 6 studies with the same dose regimen, all with a loading dose of 100 mg/kg infused before skin incision and a maintenance dose of 10 mg/kg/h [ 8 , 9 , 15 – 17 , 19 ].…”

Section: Resultsmentioning

confidence: 99%

“…Of these 9 studies, 3 studies were RCTs [ 5 , 8 , 10 ], and the rest were non-RCTs [ 4 , 9 , 15 – 17 , 19 ]. Among these studies with the high-dose regimen, there are 6 studies with the same dose regimen, all with a loading dose of 100 mg/kg infused before skin incision and a maintenance dose of 10 mg/kg/h [ 8 , 9 , 15 – 17 , 19 ]. Of these 8 studies, 3 studies were RCTs [ 7 , 13 , 21 ], and the rest were non-RCTs [ 11 , 12 , 14 , 18 , 20 ].…”

Section: Resultsmentioning

confidence: 99%

“…Table 2 shows the risk of bias assessment for the 11 non-RCTs [ 4 , 9 , 11 , 12 , 14 – 20 ]. According to the NOS, 5 studies received 8 points [ 11 , 14 , 16 , 17 , 20 ], and 6 studies received 7 points [ 4 , 9 , 12 , 15 , 18 , 19 ], indicating that the quality of included studies was acceptable.…”

Section: Resultsmentioning

confidence: 99%

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Different Dose Regimens of Intravenous Tranexamic Acid in Adolescent Spinal Deformity Surgery: A Systematic Review and Meta-Analysis

Xiong

Zhang

et al. 2020

BioMed Research International

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Objective. To evaluate the efficacy and safety of different dose regimens of intravenous (IV) tranexamic acid (TXA) in adolescent spinal deformity surgery. Methods. Two researchers independently searched multiple databases, including PubMed, Embase, Cochrane Library, and Web of Science to find studies that met the inclusion criteria. A meta-analysis was performed based on the guidelines of the Cochrane Reviewer’s Handbook. Results. Six randomized controlled trials (RCTs) and eleven non-RCTs were identified, including 1148 patients. According to different dose regimens of IV TXA, the included studies were divided into the high-dose group and the low-dose group. Compared with placebo, both groups had less total blood loss (TBL) (high dose: WMD = − 1737.55 , 95% CI: (-2247.16, -1227.94), P < 0.001 , I 2 = 0 % ; low dose: WMD = − 528.67 , 95% CI: (-666.06, -391.28), P < 0.001 , I 2 = 0 % ), intraoperative blood loss (IBL) (high dose: WMD = − 301.48 , 95% CI: (-524.3, -78.66), P = 0.008 , I 2 = 60.3 % ; low dose: WMD = − 751.14 , 95% CI: (-967.21, -535.08), P < 0.001 , I 2 = 0 % ), and blood transfusion rates (high dose: RR = 0.19 , 95% CI: (0.1, 0.37), P < 0.001 , I 2 = 0 % ; low dose: RR = 0.4 , 95% CI: (0.18, 0.91), P = 0.029 , I 2 = 57 % ). High-dose IV TXA use was associated with more vertebral fusion segments ( WMD = 0.53 , 95% CI: (0.23, 0.82), P < 0.001 , I 2 = 31.2 % ). Low-dose IV TXA use was associated with shorter operative time ( WMD = − 18.43 , 95% CI: (-26.68, -10.17), P < 0.001 , I 2 = 0 % ). Conclusion. High-dose and low-dose IV TXA were effective in reducing TBL, IBL, and blood transfusion rates without increasing complications in adolescent patients undergoing spinal deformity surgery. Low-dose IV TXA was effective in reducing the operative time. Both the high-dose and low-dose groups had similar preoperative and postoperative Hb levels compared to the control group.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Different Dose Regimens of Intravenous Tranexamic Acid in Adolescent Spinal Deformity Surgery: A Systematic Review and Meta-Analysis

Xiong

Zhang

et al. 2020

BioMed Research International

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“…Wound healing was severely impaired in plasminogendeficient mice [15][16][17][18], and treatment with TXA led to a distinct aggravation of staphylococcal septic arthritis and sepsis in mice [13]. However, as mentioned above, a large block of clinical evidence shows no such increase in the postoperative surgical site or deep infection in major surgeries such as knee and hip arthroplasties, spinal surgery, and scoliosis and trauma emergent surgeries [9,[19][20][21]. Its safety and minor effect on wound healing were also examined in severe military battle-induced cases in which TXA was given in the pre-hospital setting before wound debridement and antibiotic treatment.…”

Section: Introductionmentioning

confidence: 99%

“…TXA is a synthetic analog of the amino acid lysine and acts as an anti-fibrinolytic agent by competitively blocking lysine binding sites on plasminogen molecules, thereby reducing blood loss and transfusion requirements in major surgeries. It has become quite popular for intraoperative use in recent years [6][7][8][9][10][11]. TXA has been prescribed both intraoperatively and perioperatively in various spine procedures, including large-scale scoliosis correction surgeries [9,12].…”

Section: Introductionmentioning

confidence: 99%

Use of Intraoperative Tranexamic Acid and Wound Complications in Spine Surgery: A Retrospective Cohort Study

et al. 2020

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This study aims to examine the effect of tranexamic acid (TXA) on postoperative wound healing in spine surgery. Overview of Literature: TXA (Cyklokapron, Hexakapron) is a widely used anti-fibrinolytic drug that is shown to be effective in mitigating hemorrhage during and after surgery by competitively blocking plasminogen in fibrinolytic cascade. Plasminogen also plays a role in inflammatory and infectious diseases. The modulation of this role by TXA may influence the development of postoperative infectious complications. Methods: We collected and reviewed the charts of 110 patients who underwent spine surgery at our academic center. We used multivariate regression analysis to assess the factors affecting surgical site infection (SSI). Results: Of the 110 patients included in this study, 21 patients (19%) were categorized as having postoperative wound complications, 16 patients (14%) had deep or superficial wound infection, and 5 patients (4%) had wound dehiscence. Patients with a higher surgical invasiveness index score, longer surgeries, and older patients were found to be at risk for wound complications. TXA was determined not to be a direct risk factor for wound healing complications and SSIs. Conclusions: We found no risk of wound healing complications and SSI directly attributable to preoperative and intraoperative treatment with TXA in spine surgeries.

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Efficacy of topical versus intravenous tranexamic acid in spinal deformity

et al. 2020

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Tranexamic Acid Reduced the Percent of Total Blood Volume Lost During Adolescent Idiopathic Scoliosis Surgery

Cited by 19 publications

References 18 publications

Different Dose Regimens of Intravenous Tranexamic Acid in Adolescent Spinal Deformity Surgery: A Systematic Review and Meta-Analysis

Different Dose Regimens of Intravenous Tranexamic Acid in Adolescent Spinal Deformity Surgery: A Systematic Review and Meta-Analysis

Use of Intraoperative Tranexamic Acid and Wound Complications in Spine Surgery: A Retrospective Cohort Study

Efficacy of topical versus intravenous tranexamic acid in spinal deformity

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