Tranexamic acid to reduce operative blood loss in brain tumor surgery: A meta-analysis

Prastikarunia, Resi; Wahyuhadi, Joni; Susilo, Rahadian Indarto; Haq, Irwan Barlian Immadoel

doi:10.25259/sni_19_2021

Cited by 4 publications

(3 citation statements)

References 40 publications

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“…Another recent meta-analysis including three studies and 200 patients showed a reduction of peri-operative blood loss when TXA was used (mean difference of −292.8 ml; 95% CI −431 to −153 ml; P < 0.05). However, the use of blood transfusion was not significantly changed in the TXA cohort 957 . This is in contrast to a recent RCT in which 30 patients underwent meningioma resection with and without TXA treatment.…”

Section: Discussioncontrasting

confidence: 85%

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Management of severe peri-operative bleeding: Guidelines from the European Society of Anaesthesiology and Intensive Care

Kietaibl

Ahmed

Afshari

et al. 2023

European Journal of Anaesthesiology

142

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BACKGROUND Management of peri-operative bleeding is complex and involves multiple assessment tools and strategies to ensure optimal patient care with the goal of reducing morbidity and mortality. These updated guidelines from the European Society of Anaesthesiology and Intensive Care (ESAIC) aim to provide an evidence-based set of recommendations for healthcare professionals to help ensure improved clinical management. DESIGN A systematic literature search from 2015 to 2021 of several electronic databases was performed without language restrictions. Grading of Recommendations, Assessment, Development and Evaluation (GRADE) was used to assess the methodological quality of the included studies and to formulate recommendations. A Delphi methodology was used to prepare a clinical practice guideline. RESULTS These searches identified 137 999 articles. All articles were assessed, and the existing 2017 guidelines were revised to incorporate new evidence. Sixteen recommendations derived from the systematic literature search, and four clinical guidances retained from previous ESAIC guidelines were formulated. Using the Delphi process on 253 sentences of guidance, strong consensus (>90% agreement) was achieved in 97% and consensus (75 to 90% agreement) in 3%. DISCUSSION Peri-operative bleeding management encompasses the patient's journey from the pre-operative state through the postoperative period. Along this journey, many features of the patient's pre-operative coagulation status, underlying comorbidities, general health and the procedures that they are undergoing need to be taken into account. Due to the many important aspects in peri-operative nontrauma bleeding management, guidance as to how best approach and treat each individual patient are key. Understanding which therapeutic approaches are most valuable at each timepoint can only enhance patient care, ensuring the best outcomes by reducing blood loss and, therefore, overall morbidity and mortality. CONCLUSION All healthcare professionals involved in the management of patients at risk for surgical bleeding should be aware of the current therapeutic options and approaches that are available to them. These guidelines aim to provide specific guidance for bleeding management in a variety of clinical situations.

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Section: Discussioncontrasting

confidence: 85%

“…However, the use of blood transfusion was not significantly changed in the TXA cohort. 957 This is in contrast to a recent RCT in which 30 patients underwent meningioma resection with and without TXA treatment. In this study, a clear benefit of TXA was shown in terms of less blood loss (616 AE 393 versus 1150 AE 416 ml).…”

Section: Intracranial Surgerymentioning

confidence: 76%

Management of severe peri-operative bleeding: Guidelines from the European Society of Anaesthesiology and Intensive Care

Kietaibl

Ahmed

Afshari

et al. 2023

European Journal of Anaesthesiology

142

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“…Tranexamic acid (TXA) is a commonly used antifibrinolytic drug, which can inhibit the conversion of single‐chain tissue plasminogen activator (set‐PA) to its double‐chain form (tct‐PA) by plasmin, 1 thereby inhibiting fibrinolysis and reducing bleeding. At present, TXA has been widely used in orthopedics surgeries, 2 , 3 brain surgeries, 4 gynecological surgeries, 5 and so on. Among orthopedic surgeries, TXA was used in joint replacement, 6 , 7 fracture surgery, 8 spinal surgery 9 and osteotomy 10 , 11 to reduce perioperative blood loss and transfusion requirements.…”

Section: Introductionmentioning

confidence: 99%

Topical Use of Low‐dose Tranexamic Acid Has no Effect on Drainage Volume after Medial Open Wedge High Tibial Osteotomy: A Case Control Study

Zheng,

Han,

Zhao

et al. 2024

Orthopaedic Surgery

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ObjectiveMany studies reported that tranexamic acid (TXA) was effective in reducing surgical blood loss in the perioperative period of medial open wedge high tibial osteotomy (MOWHTO). However, few studies focused on the simple topical use of TXA in MOWHTO, and the modality and dosage of topical use of TXA varied. The purpose of this study was to observe the effect of topical use of low‐dose TXA on drainage volume after MOWHTO, and to analyze the related influencing factors.MethodsData of patients who underwent MOWHTO combined with arthroscopic knee surgery in our department from January 2019 to September 2021 were retrospectively analyzed. A total of 105 patients (38 males and 67 females, aged 57.7 ± 7.5 years) were included in this study who received topical TXA or no TXA. The patients were divided into three groups: control group (39 cases), 0.5 g TXA group (40 cases), 1 g TXA group (26 cases). Postoperative drainage volume, wound healing, incidence of hematoma and deep venous thrombosis (DVT) were observed and analyzed in the three groups. The effects of gender, hypertension and diabetes on postoperative drainage volume were analyzed using a t‐test. The correlation between age, body mass index (BMI), osteotomy gap and postoperative drainage volume were analyzed using the Pearson correlation coefficient.ResultsThe average postoperative drainage volume of the control group was 259.54 ± 226.33 mL, that of the 0.5 g TXA group was 277.18 ± 177.68 mL, and that of the 1 g TXA group was 229.15 ± 219.93 mL. There was no statistically significant difference in postoperative drainage volume among the three groups (F = 0.423, p = 0.656). There was no local hematoma and wound infection in the three groups. The wound fat liquefaction was found in one patient of the control group. The incidence of DVT was 38.9% (7/18) and 57.1% (8/14) in the control group and 0.5 TXA group, respectively. There was no significant difference in the incidence of DVT between the above two groups (p = 0.476). The average postoperative drainage volume of male patients in the three groups was higher than that of female patients, and the differences were statistically significant (p < 0.05). There was no correlation between age, BMI, osteotomy gap and postoperative drainage volume in the three groups (p > 0.05).ConclusionTopical use of low‐dose TXA has no significant effect on drainage volume after MOWHTO. The drainage volume after MOWHTO in male patients was more than that in female patients. Topical administration of low‐dose TXA does not increase postoperative complications, such as DVT and hematoma.

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Prophylactic tranexamic acid among women undergoing vaginal delivery to reduce postpartum blood loss and related morbidities: A systematic review and meta-analysis of 17 randomized controlled trials

Abu‐Zaid

Baradwan

Alshahrani

et al. 2022

Journal of Gynecology Obstetrics and Human Reproduction

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Tranexamic acid to reduce operative blood loss in brain tumor surgery: A meta-analysis

Cited by 4 publications

References 40 publications

Management of severe peri-operative bleeding: Guidelines from the European Society of Anaesthesiology and Intensive Care

Management of severe peri-operative bleeding: Guidelines from the European Society of Anaesthesiology and Intensive Care

Topical Use of Low‐dose Tranexamic Acid Has no Effect on Drainage Volume after Medial Open Wedge High Tibial Osteotomy: A Case Control Study

Prophylactic tranexamic acid among women undergoing vaginal delivery to reduce postpartum blood loss and related morbidities: A systematic review and meta-analysis of 17 randomized controlled trials

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