A comparative study of the postoperative allogeneic blood-sparing effects of tranexamic acid and of desmopressin after total knee replacement

Transfusion
E ZoharR Jedeikin

Abstract

Tissue hypoxia and reperfusion induce abnormal hemostatic function. Therefore, bleeding after total knee replacement (TKR) may be a result of a tourniquet-induced imbalance of the procoagulant and fibrinolytic systems. Because laboratory confirmation of tourniquet-induced abnormal hemostasis is difficult to obtain, indirect evidence must be sought. A prospective, single-blind study of 40 patients undergoing TKR was performed. In the tranexamic acid (TA) group, in the 30 minutes before the limb tourniquet was deflated, an IV bolus dose of TA (15 mg/kg) was administered. Thereafter, a constant IV infusion of 10 mg per kg per hour was administered until 12 hours after tourniquet deflation. In the desmopressin group, desmopressin (0.3 mg/kg) and saline were administered by a similar protocol. No blood was administered intraoperatively. A postoperative Hct <27 percent constituted the postoperative transfusion trigger. Patients were examined daily for signs of lower-limb deep vein thrombosis, and they underwent lower-limb Doppler ultrasound on postoperative Day 5. Three months after surgery, the incidence of delayed thromboembolic events was assessed. During the first 12 postoperative hours, blood accumulation in the surgical drain w...Continue Reading

Associated Clinical Trials

References

May 7, 1977·Lancet·L KlenermanY Stirling
Jan 6, 1983·The New England Journal of Medicine·P M MannucciT S Zimmerman
Oct 1, 1994·The Journal of Bone and Joint Surgery. American Volume·T A KarnezisP Reilly
Jul 23, 1998·The New England Journal of Medicine·P M Mannucci
Jul 2, 1999·European Journal of Vascular and Endovascular Surgery : the Official Journal of the European Society for Vascular Surgery·A HolmbergD Bergqvist
Sep 18, 2007·Journal of Clinical Anesthesia·Steven M Neustein

❮ Previous
Next ❯

Citations

Jan 25, 2003·Vox Sanguinis·T Kovesi, D Royston
Oct 1, 2013·Knee Surgery, Sports Traumatology, Arthroscopy : Official Journal of the ESSKA·Pierluigi AntinolfiGiuliano Cerulli
Oct 27, 2006·Anesthesiology·Paul ZuffereySerge Molliex
May 10, 2013·European Journal of Anaesthesiology·Sibylle A Kozek-LangeneckerPiet Wyffels
Jul 28, 2013·The Journal of Arthroplasty·Blake P GilletteRafael J Sierra
Jun 28, 2015·The Journal of Arthroplasty·Daniel R WhitingHugh M Smith
May 12, 2007·American Journal of Hematology·Massimo Franchini
Oct 24, 2013·Transfusion and Apheresis Science : Official Journal of the World Apheresis Association : Official Journal of the European Society for Haemapheresis·Mohammad AlipourHadi Makhmalbaf
Dec 14, 2011·The Journal of Bone and Joint Surgery. British Volume·S AlshrydaJ M Mason
Jul 12, 2017·The Cochrane Database of Systematic Reviews·Michael J DesboroughLise J Estcourt
Jul 21, 2012·Clinical Orthopaedics and Related Research·Blake P GilletteRafael J Sierra
Jul 3, 2013·Clinical Orthopaedics and Related Research·Daniel R WhitingRafael J Sierra

❮ Previous
Next ❯

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.