Tranexamic Acid and Tourniquet: Which Combination Reduces Blood Loss Most Effectively?
Humans
Tranexamic Acid
/ therapeutic use
Tourniquets
Female
Male
Aged
Antifibrinolytic Agents
/ therapeutic use
Blood Loss, Surgical
/ prevention & control
Arthroplasty, Replacement, Knee
/ methods
Middle Aged
Aged, 80 and over
Blood Transfusion
/ statistics & numerical data
Hemoglobins
/ analysis
Treatment Outcome
Retrospective Studies
Journal
Nigerian journal of clinical practice
ISSN: 1119-3077
Titre abrégé: Niger J Clin Pract
Pays: India
ID NLM: 101150032
Informations de publication
Date de publication:
01 Apr 2024
01 Apr 2024
Historique:
received:
01
01
2024
accepted:
27
02
2024
medline:
29
4
2024
pubmed:
29
4
2024
entrez:
28
4
2024
Statut:
ppublish
Résumé
Blood loss during and after total knee arthroplasty (TKA) can lead to substantial morbidity and the need for blood transfusions. There are several methods to minimize blood loss and decrease transfusion rates in patients undergoing TKA. Tranexamic acid, an antifibrinolytic agent with known efficacy for achieving these goals, is combined with tourniquets to reduce bleeding in arthroplasty surgeries. Our study investigated the effects of various combinations of tranexamic acid and tourniquet use on bleeding in knee arthroplasty in 558 patients. We aimed to determine the method that would provide the least blood loss and transfusion need in knee arthroplasty surgery. Between January 2018 and December 2022, 558 patients aged between 55 and 85 years underwent TKA surgery for grade 4 gonarthrosis in our clinic, and their decrease in hemoglobin value and whether they were transfused or not were analyzed. The patients were divided into four groups based on use of tranexamic acid and tourniquet. Demographic variables and patient data (body mass index, INR values, and preoperative hemoglobin values) were recorded. There were 558 patients with a mean age of 68.19 (67 ± 6.949) years. In group 1, tranexamic acid was not used in 128 patients and tourniquet was used only during cementation; in group 2, in 132 patients, tranexamic acid was not used and tourniquet was used throughout the surgery; in group 3, in 158 patients, tranexamic acid was used and tourniquet was used throughout the surgery; in group 4, in 140 patients, tranexamic acid was used and tourniquet was used only during cementation. The decrease in hemoglobin value and transfusion rate was lowest in group 3 and highest in group 1. Besides, there was a greater decrease in hemoglobin value in group 2 than in group 4 and the transfusion rate was similar. This clinical study showed that using tranexamic acid and a tourniquet throughout surgery significantly reduced the decrease in hemoglobin value and the need for transfusion.
Sections du résumé
BACKGROUND
BACKGROUND
Blood loss during and after total knee arthroplasty (TKA) can lead to substantial morbidity and the need for blood transfusions. There are several methods to minimize blood loss and decrease transfusion rates in patients undergoing TKA. Tranexamic acid, an antifibrinolytic agent with known efficacy for achieving these goals, is combined with tourniquets to reduce bleeding in arthroplasty surgeries. Our study investigated the effects of various combinations of tranexamic acid and tourniquet use on bleeding in knee arthroplasty in 558 patients.
AIM
OBJECTIVE
We aimed to determine the method that would provide the least blood loss and transfusion need in knee arthroplasty surgery.
METHODS
METHODS
Between January 2018 and December 2022, 558 patients aged between 55 and 85 years underwent TKA surgery for grade 4 gonarthrosis in our clinic, and their decrease in hemoglobin value and whether they were transfused or not were analyzed. The patients were divided into four groups based on use of tranexamic acid and tourniquet. Demographic variables and patient data (body mass index, INR values, and preoperative hemoglobin values) were recorded.
RESULTS
RESULTS
There were 558 patients with a mean age of 68.19 (67 ± 6.949) years. In group 1, tranexamic acid was not used in 128 patients and tourniquet was used only during cementation; in group 2, in 132 patients, tranexamic acid was not used and tourniquet was used throughout the surgery; in group 3, in 158 patients, tranexamic acid was used and tourniquet was used throughout the surgery; in group 4, in 140 patients, tranexamic acid was used and tourniquet was used only during cementation. The decrease in hemoglobin value and transfusion rate was lowest in group 3 and highest in group 1. Besides, there was a greater decrease in hemoglobin value in group 2 than in group 4 and the transfusion rate was similar.
CONCLUSIONS
CONCLUSIONS
This clinical study showed that using tranexamic acid and a tourniquet throughout surgery significantly reduced the decrease in hemoglobin value and the need for transfusion.
Identifiants
pubmed: 38679776
doi: 10.4103/njcp.njcp_3_24
pii: 01253091-202404000-00016
doi:
Substances chimiques
Tranexamic Acid
6T84R30KC1
Antifibrinolytic Agents
0
Hemoglobins
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
521-527Informations de copyright
Copyright © 2024 Copyright: © 2024 Nigerian Journal of Clinical Practice.
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