The Efficacy and Safety of Combination of Intravenous and Topical Tranexamic Acid in Revision Hip Arthroplasty: A Randomized, Controlled Trial
| Autor: | Yi Zeng, Bin Shen, Ti-min Yang, Yuangang Wu, Fei Cao, Haibo Si |
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| Rok vydání: | 2016 |
| Předmět: |
Male
Reoperation medicine.medical_specialty Blood transfusion Deep vein medicine.medical_treatment Administration Topical Arthroplasty Replacement Hip Blood Loss Surgical 03 medical and health sciences Hemoglobins 0302 clinical medicine Antifibrinolytic agent medicine Animals Humans Orthopedics and Sports Medicine Blood Transfusion 030212 general & internal medicine Prospective Studies Perioperative Period Aged Venous Thrombosis 030222 orthopedics business.industry Perioperative Middle Aged medicine.disease Thrombosis Antifibrinolytic Agents Surgery Pulmonary embolism Venous thrombosis medicine.anatomical_structure Tranexamic Acid Anesthesia Administration Intravenous Female business Pulmonary Embolism Tranexamic acid medicine.drug |
| Zdroj: | The Journal of arthroplasty. 31(11) |
| ISSN: | 1532-8406 |
| Popis: | Revision total hip arthroplasty (THA) is associated with substantial blood loss and a high probability of blood transfusion in the perioperative period. This study aimed to evaluate the efficacy and safety of combination of intravenous (IV) and topical tranexamic acid (TXA) in revision THA.Eighty-four consecutive patients undergoing revision THA were randomized into combined group and IV-TXA group. Patients in the combined group were given intravenously 15 mg/kg TXA as a preoperative, and topical TXA solution was applied at a concentration of 3 g TXA per 100-mL saline during the different procedure points. Patients in the IV-TXA group were given intravenously 15 mg/kg TXA alone.The mean total blood loss, drainage volume, and maximum hemoglobin drop were significantly lower in the combined group than the IV-TXA group (P.001, P.001, P.001, respectively). Compared with the IV-TXA group, the amount of blood transfusions and number of blood transfusions required were decreased dramatically in the combined group (P = .027, P.001, respectively). One deep vein thrombosis and 4 calf muscular vein thrombosis in the combined group and 3 calf muscular vein thrombosis in the IV-TXA were detected by the Doppler ultrasound. No pulmonary embolism was observed and no significant differences were found in other complications between the 2 groups.This study showed that combined administration of IV and topical TXA in revision THA can effectively decrease total blood loss and number of blood transfusions required without increasing the risk of deep vein thrombosis or/and pulmonary embolism compared with IV-TXA alone. |
| Databáze: | OpenAIRE |
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