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Tranexamic acid reduces blood loss in total hip replacement surgery.

Ekbäck, G; Axelsson, K; Ryttberg, L; Edlund, B; Kjellberg, J; Weckström, J; Carlsson, O and Schött, Ulf LU (2000) In Anesthesia and Analgesia 91(5). p.1124-1130
Abstract
Intraoperatively administered, tranexamic acid (TA) does not reduce bleeding in total hip replacement (THR). Therefore, its prophylactic use was attempted in the present study because this has been shown to be more effective in cardiac surgery. We investigated 40 patients undergoing THR in a prospective, randomized, double-blinded study. Twenty patients received TA given in two bolus doses of 10 mg/kg each, the first just before surgical incision and the second 3 h later. In addition, a continuous infusion of TA, 1.0 mg. kg(-1). h(-1) for 10 h, was given after the first bolus dose. The remaining 20 patients formed a control group. Both groups used preoperative autologous blood donation and intraoperative autotransfusion. Intraoperative... (More)
Intraoperatively administered, tranexamic acid (TA) does not reduce bleeding in total hip replacement (THR). Therefore, its prophylactic use was attempted in the present study because this has been shown to be more effective in cardiac surgery. We investigated 40 patients undergoing THR in a prospective, randomized, double-blinded study. Twenty patients received TA given in two bolus doses of 10 mg/kg each, the first just before surgical incision and the second 3 h later. In addition, a continuous infusion of TA, 1.0 mg. kg(-1). h(-1) for 10 h, was given after the first bolus dose. The remaining 20 patients formed a control group. Both groups used preoperative autologous blood donation and intraoperative autotransfusion. Intraoperative bleeding was significantly less (P: = 0.001) in the TA group compared with the control group (630 +/- 220 mL vs 850 +/- 260 mL). Postoperative drainage bleeding was correspondingly less (P: = 0.001) (520 +/- 280 vs 920 +/- 410 mL). Up to 10 h postoperatively, plasma D-dimer concentration was halved in the TA group compared with the control group. One patient in each group had an ultrasound-verified late deep vein thrombosis. In conclusion, we found TA, administrated before surgical incision, to be efficient in reducing bleeding during THR. Implications: In a prospective, double-blinded study of 40 patients undergoing total hip replacement, the preoperative administration of tranexamic acid reduced bleeding by 35%, probably by decreasing induced fibrinolysis. Whether tranexamic acid therapy can replace predonation of autologous blood or intraoperative autotransfusion requires further study. (Less)
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organization
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Contribution to journal
publication status
published
subject
keywords
Fibrin Fibrinogen Degradation Products: analysis, Surgical: prevention & control, Blood Loss, Antifibrinolytic Agents: therapeutic use, Blood Coagulation: drug effects, Tranexamic Acid: therapeutic use
in
Anesthesia and Analgesia
volume
91
issue
5
pages
1124 - 1130
publisher
Lippincott Williams & Wilkins
external identifiers
  • pmid:11049894
  • scopus:0033757201
ISSN
1526-7598
language
English
LU publication?
yes
id
ca016761-494f-4ba4-b165-4dd121ac2bdb (old id 3634362)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/11049894?dopt=Abstract
date added to LUP
2013-07-02 13:05:58
date last changed
2017-10-01 05:01:00
@article{ca016761-494f-4ba4-b165-4dd121ac2bdb,
  abstract     = {Intraoperatively administered, tranexamic acid (TA) does not reduce bleeding in total hip replacement (THR). Therefore, its prophylactic use was attempted in the present study because this has been shown to be more effective in cardiac surgery. We investigated 40 patients undergoing THR in a prospective, randomized, double-blinded study. Twenty patients received TA given in two bolus doses of 10 mg/kg each, the first just before surgical incision and the second 3 h later. In addition, a continuous infusion of TA, 1.0 mg. kg(-1). h(-1) for 10 h, was given after the first bolus dose. The remaining 20 patients formed a control group. Both groups used preoperative autologous blood donation and intraoperative autotransfusion. Intraoperative bleeding was significantly less (P: = 0.001) in the TA group compared with the control group (630 +/- 220 mL vs 850 +/- 260 mL). Postoperative drainage bleeding was correspondingly less (P: = 0.001) (520 +/- 280 vs 920 +/- 410 mL). Up to 10 h postoperatively, plasma D-dimer concentration was halved in the TA group compared with the control group. One patient in each group had an ultrasound-verified late deep vein thrombosis. In conclusion, we found TA, administrated before surgical incision, to be efficient in reducing bleeding during THR. Implications: In a prospective, double-blinded study of 40 patients undergoing total hip replacement, the preoperative administration of tranexamic acid reduced bleeding by 35%, probably by decreasing induced fibrinolysis. Whether tranexamic acid therapy can replace predonation of autologous blood or intraoperative autotransfusion requires further study.},
  author       = {Ekbäck, G and Axelsson, K and Ryttberg, L and Edlund, B and Kjellberg, J and Weckström, J and Carlsson, O and Schött, Ulf},
  issn         = {1526-7598},
  keyword      = {Fibrin Fibrinogen Degradation Products: analysis,Surgical: prevention & control,Blood Loss,Antifibrinolytic Agents: therapeutic use,Blood Coagulation: drug effects,Tranexamic Acid: therapeutic use},
  language     = {eng},
  number       = {5},
  pages        = {1124--1130},
  publisher    = {Lippincott Williams & Wilkins},
  series       = {Anesthesia and Analgesia},
  title        = {Tranexamic acid reduces blood loss in total hip replacement surgery.},
  volume       = {91},
  year         = {2000},
}