Multiple boluses of intravenous tranexamic acid to reduce hidden blood loss and the inflammatory response following enhanced-recovery primary total hip arthroplasty: a randomised clinical trial

The Bone & Joint Journal
Jin-Wei XieF Pei

Abstract

The aim of this study was to examine the efficacy and safety of multiple boluses of intravenous (IV) tranexamic acid (TXA) on the hidden blood loss (HBL) and inflammatory response following primary total hip arthroplasty (THA). A total of 150 patients were allocated randomly to receive a single bolus of 20 mg/kg IV TXA before the incision (group A), a single bolus followed by a second bolus of 1 g IV-TXA three hours later (group B) or a single bolus followed by two boluses of 1 g IV-TXA three and six hours later (group C). All patients were treated using a standard peri-operative enhanced recovery protocol. Primary outcomes were HBL and the level of haemoglobin (Hb) as well as the levels of C-reactive protein (CRP) and interleukin-6 (IL-6) as markers of inflammation. Secondary outcomes included the length of stay in hospital and the incidence of venous thromboembolism (VTE). The mean HBL was significantly lower in group C (402.13 ml standard deviation (sd) 225.97) than group A (679.28 ml sd 277.16, p < 0.001) or B (560.62 ml sd 295.22, p = 0.010). The decrease in the level of Hb between the pre-operative baseline and the level on the third post-operative day was 30.82 g/L (sd 6.31 g/L) in group A, 27.16 g/L (sd 6.83) in group B...Continue Reading

References

Jan 1, 1985·The Journal of Bone and Joint Surgery. British Volume·R P Ficat
Mar 1, 1983·Anesthesiology·J B Gross
Sep 30, 2000·Archives of Orthopaedic and Trauma Surgery·K IdoS Kuriyama
Sep 28, 2004·The Journal of Bone and Joint Surgery. British Volume·J Aderinto, I J Brenkel
Oct 31, 2007·Acta chirurgica Belgica·M A ClaeysP Haentjens
Jun 2, 2009·The Journal of Bone and Joint Surgery. British Volume·K RajesparanR E Field
Jan 12, 2010·Clinical Orthopaedics and Related Research·Fiona E RalleyDouglas D R Naudie
Jan 5, 2011·The Journal of Bone and Joint Surgery. British Volume·M SukeikJ M Mason
Jan 25, 2011·The Journal of Arthroplasty·Xudong LiuBingfang Zeng
Mar 16, 2012·Clinical Orthopaedics and Related Research·Rajesh N ManiarParul R Maniar
May 23, 2012·BMJ : British Medical Journal·Katharine KerIan Roberts
Jul 4, 2012·Critical Care : the Official Journal of the Critical Care Forum·Anne GodierBeverley J Hunt
Sep 26, 2013·Hip International : the Journal of Clinical and Experimental Research on Hip Pathology and Therapy·Hervé Hourlier, Peter Fennema
Mar 25, 2014·Medicinal Research Reviews·Rami A Al-Horani, Umesh R Desai
Apr 4, 2014·Blood Coagulation & Fibrinolysis : an International Journal in Haemostasis and Thrombosis·Yue ZouKang Sun
Mar 18, 2015·Clinical Chemistry and Laboratory Medicine : CCLM·Marcin Krzysztof WaskoJacek Kowalczewski
Sep 24, 2015·Hip International : the Journal of Clinical and Experimental Research on Hip Pathology and Therapy·Jinwei XieFuxing Pei
Aug 9, 2016·The Journal of Arthroplasty·Qunn Jid LeeYiu Chung Wong
Nov 22, 2016·The Journal of Arthroplasty·Nicholas A BedardJohn J Callaghan
Dec 13, 2016·British Journal of Anaesthesia·E M Soffin, J T YaDeau
Feb 17, 2017·British Journal of Anaesthesia·S M Goobie

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Citations

Apr 12, 2018·Journal of Investigative Surgery : the Official Journal of the Academy of Surgical Research·Ji-Qi WangYou-Ming Zhao
Mar 8, 2019·The Journal of Bone and Joint Surgery. American Volume·Duan WangWei-Nan Zeng
Aug 12, 2018·JAMA Otolaryngology-- Head & Neck Surgery·Sara Juliana de A de VasconcellosPaulo Ricardo Saquete Martins-Filho
Jan 1, 2021·HSS Journal : the Musculoskeletal Journal of Hospital for Special Surgery·Elina HuerfanoAlejandro Gonzalez Della Valle
Feb 26, 2021·The American Journal of Sports Medicine·William L JohnsNirav K Patel

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