Effect of Tranexamic Acid on Blood Loss and Blood Transfusion Reduction after Total Knee Arthroplasty
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purpose: Total knee arthroplasty (TKA) accompanies the risk of bleeding and need for transfusion. There are several methods to reduce post-operative blood loss and blood transfusion. One such method is using tranexamic acid during TKA. The purpose of this study was to confirm whether tranexamic acid reduces postoperative blood loss and blood transfusion after TKA. Materials and Methods: A total of 100 TKA patients were included in the study. The tranexamic acid group consisted of 50 patients who received an intravenous injection of tranexamic acid. The control included 50 patients who received a placebo injection. The amounts of drainage, postoperative hemoglobin, and transfusion were compared between the groups.results: The mean amount of drainage was lower in the tranexamic acid group (580.6±355.0 mL) than the control group (886.0±375.5 mL). There was a reduction in the transfusion rate in the tranexamic acid group (48%) compared with the control group (64%). The hemoglobin level was higher in the tranexamic acid group than in the control group at 24 hours postoperatively. The mean units of transfusion were smaller in the tranexamic acid group (0.76 units) than in the control group (1.28 units).conclusions: Our data suggest that intravenous injection of tranexamic acid decreases the total blood loss and transfusion after TKA.
Abstract
purpose: Total knee arthroplasty (TKA) accompanies the risk of bleeding and need for transfusion. There are several methods to reduce post-operative blood loss and blood transfusion. One such method is using tranexamic acid during TKA. The purpose of this study was to confirm whether tranexamic acid reduces postoperative blood loss and blood transfusion after TKA. Materials and Methods: A total of 100 TKA patients were included in the study. The tranexamic acid group consisted of 50 patients who received an intravenous injection of tranexamic acid. The control included 50 patients who received a placebo injection. The amounts of drainage, postoperative hemoglobin, and transfusion were compared between the groups.results: The mean amount of drainage was lower in the tranexamic acid group (580.6±355.0 mL) than the control group (886.0±375.5 mL). There was a reduction in the transfusion rate in the tranexamic acid group (48%) compared with the control group (64%). The hemoglobin level was higher in the tranexamic acid group than in the control group at 24 hours postoperatively. The mean units of transfusion were smaller in the tranexamic acid group (0.76 units) than in the control group (1.28 units).conclusions: Our data suggest that intravenous injection of tranexamic acid decreases the total blood loss and transfusion after TKA.
참고문헌 (30)
- Prasad N, "Blood loss in total knee arthroplasty : an analysis of risk factors", Int Orthop, 31, pp.39~44 (2007)
- Banerjee S, "Intraoperative nonpharmacotherapeutic blood management strategies in total knee arthroplasty", J Knee Surg, 26, pp.387~393 (2013)
- Cushner FD, "Blood loss in total knee arthroplasty", Clin Orthop Relat Res, (269), pp.98~101 (1991)
- Maxwell MJ, "Complications of blood transfusion", Contin Educ Anaesth Crit Care Pain, 6, pp.225~229 (2006)
- Bower WF, "Perioperative blood transfusion increases length of hospital stay and number of postoperative complications in non-cardiac surgical patients", Hong Kong Med J, 16, pp.116~120 (2010)
- Spahn DR, "Anemia and patient blood management in hip and knee surgery : a systematic review of the literature", Anesthesiology, 113, pp.482~495 (2010)
- Juelsgaard P, "Hypotensive epidural anesthesia in total knee replacement without tourniquet : reduced blood loss and transfusion", Reg Anesth Pain Med, 26, pp.105~110 (2001)
- Wang GJ, "Use of fibrin sealant to reduce bloody drainage and hemoglobin loss after total knee arthroplasty : a brief note on a randomized prospective trial", J Bone Joint Surg Am, 83, pp.1503~1505 (2001)
- Prasad N, "Comparison between two methods of drain clamping after total knee arthroplasty", Arch Orthop Trauma Surg, 125, pp.381~384 (2005)
- Shen PC, "Comparison between 4-hour clamping drainage and nonclamping drainage after total knee arthroplasty", J Arthroplasty, 20, pp.909~913 (2005)
- Tsumara N, "A prospective comparison of clamping the drain or postoperative salvage of blood in reducing blood loss after total knee arthroplasty", J Bone Joint Surg Br, 88, pp.49~53 (2006)
- Yamada K, "Comparison between 1-hour and 24-hour drain clamping using diluted epinephrine solution after total knee arthroplasty", J Arthroplasty, 16, pp.458~462 (2001)
- Benoni G, "Fibrinolytic inhibition with tranexamic acid reduces blood loss and blood transfusion after knee arthroplasty : a prospective, randomised, double-blind study of 86 patients", J Bone Joint Surg Br, 78, pp.434~440 (1996)
- Molloy DO, "Comparison of topical fibrin spray and tranexamic acid on blood loss after total knee replacement : a prospective, randomised controlled trial", J Bone Joint Surg Br, 89, pp.306~309 (2007)
- Tanaka N, "Timing of the administration of tranexamic acid for maximum reduction in blood loss in arthroplasty of the knee", J Bone Joint Surg Br, 83, pp.702~705 (2001)
- Benoni G, "Does tranexamic acid reduce blood loss in knee arthroplasty?", Am J Knee Surg, 8, pp.88~92 (1995)
- Hynes M, "The use of tranexamic acid to reduce blood loss during total knee arthroplasty", Knee, 10, pp.375~377 (2003)
- Ho KM, "Use of intravenous tranexamic acid to reduce allogeneic blood transfusion in total hip and knee arthroplasty : a meta-analysis", Anaesth Intensive Care, 31, pp.529~537 (2003)
- Cid J, "Tranexamic acid reduces allogeneic red cell transfusions in patients undergoing total knee arthroplasty : results of a meta-analysis of randomized controlled trials", Transfusion, 45, pp.1302~1307 (2005)
- Sehat KR, "How much blood is really lost in total knee arthroplasty? : correct blood loss management should take hidden loss into account", Knee, 7, pp.151~155 (2000)
- Chen JY, "Intravenous versus intra-articular tranexamic acid in total knee arthroplasty : a double-blinded randomised controlled noninferiority trial", Knee, 23, pp.152~156 (2016)
- Veien M, "Tranexamic acid given intraoperatively reduces blood loss after total knee replacement : a randomized, controlled study", Acta Anaesthesiol Scand, 46, pp.1206~1211 (2002)
- Camarasa MA, "Efficacy of aminocaproic, tranexamic acids in the control of bleeding during total knee replacement : a randomized clinical trial", Br J Anaesth, 96, pp.576~582 (2006)
- Gomez-Barrena E, "Topical intraarticular compared with intravenous tranexamic acid to reduce blood loss in primary total knee replacement : a doubleblind, randomized, controlled, noninferiority clinical trial", J Bone Joint Surg Am, 96, pp.1937~1944 (2014)
- Pearse EO, "Early mobilisation after conventional knee replacement may reduce the risk of postoperative venous thromboembolism", J Bone Joint Surg Br, 89, pp.316~322 (2007)
- Park YG, "Incidence and fate of"symptomatic"venous thromboembolism after knee arthroplasty without pharmacologic prophylaxis in an Asian population", J Arthroplasty, 31, pp.1072~1077 (2016)
- Benoni G, "The effect of tranexamic acid on local and plasma fibrinolysis during total knee arthroplasty", Thromb Res, 85, pp.195~206 (1997)
- Nilsson IM, "Clinical pharmacology of aminocaproic and tranexamic acids", J Clin Pathol Suppl(R Coll Pathol), 14, pp.41~47 (1980)
- Gross JB, "Estimating allowable blood loss : corrected for dilution", Anesthesiology, 58, pp.277~280 (1983)
- Ma J, "Blood management of staged bilateral total knee arthroplasty in a single hospitalization period", J Orthop Surg Res, 9, pp.116~ (2014)