Waskowski, Jan; Schefold, Joerg C.; Stueber, Frank (2019). [Prophylactic use of tranexamic acid in noncardiac surgery : Update 2017]. Medizinische Klinik - Intensivmedizin und Notfallmedizin, 114(7), pp. 642-649. Springer-Medizin-Verlag 10.1007/s00063-018-0402-5
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Background. Minimising perioperative bleeding is a key goal of “patient blood management” programs. One component of respective strategies includes preventive inhibition of fibrinolysis using protease inhibitors, such as tranexamic acid (TXA). TXA inhibits plasminogen activation and plasmininduced fibrin degradation.
Objectives. The present article provides an overview of the existing literature and TXA applications in the prophylaxis of perioperative bleeding.
Methods. Literature search in PubMed/MEDLINE (U.S. National Library of Medicine®, Bethesda,MD, USA).
Results. TXA reduces perioperative blood loss and transfusion requirements in several randomized controlled trials (RCTs) and meta-analyses in the field of hip and knee arthroplasty for both intravenous and topical use. Moreover, evidence favours use of TXA in complex spine surgery and reconstructive surgery (e.g. craniosynostosis in children). Single RCTs showed benefits of TXA in abdominal hysterectomy, open prostatectomy, liver surgery and actively bleeding trauma patients. For prophylaxis of peripartum haemorrhage (PPH) following vaginal delivery or Caesarean section, TXA cannot be routinely recommended, although evidence points to benefits in actively bleeding patients. A recommendation exists for the treatment of (active) PPH. For prophylactic perioperative administration, different dosage regimens exist for adults. Most often an initial i.v. bolus of 1g or 10–15mg/kg body weight with/without repetition after 6 h or continuous infusions over 8 h is administered. Increased rates of thromboembolic events were not noted.
Conclusion. Protease inhibitors such as TXA reduce perioperative blood loss and transfusion requirements in selected surgical fields.
Item Type: |
Journal Article (Review Article) |
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Division/Institute: |
04 Faculty of Medicine > Department of Intensive Care, Emergency Medicine and Anaesthesiology (DINA) > Clinic and Policlinic for Anaesthesiology and Pain Therapy 04 Faculty of Medicine > Department of Intensive Care, Emergency Medicine and Anaesthesiology (DINA) > Clinic of Intensive Care |
UniBE Contributor: |
Waskowski, Jan, Schefold, Jörg Christian, Stüber, Frank |
Subjects: |
600 Technology > 610 Medicine & health |
ISSN: |
2193-6218 |
Publisher: |
Springer-Medizin-Verlag |
Language: |
German |
Submitter: |
Jeannie Wurz |
Date Deposited: |
23 Jan 2019 15:40 |
Last Modified: |
27 Mar 2023 15:16 |
Publisher DOI: |
10.1007/s00063-018-0402-5 |
PubMed ID: |
29368267 |
Additional Information: |
Abstract is available in both German and English |
BORIS DOI: |
10.7892/boris.122596 |
URI: |
https://boris.unibe.ch/id/eprint/122596 |
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