Multiple-Dose Intravenous Tranexamic Acid Further Reduces Hidden Blood Loss After Total Hip Arthroplasty: A Randomized Controlled Trial

The Journal of Arthroplasty
Yiting LeiFuxing Pei

Abstract

The most appropriate dose of tranexamic acid in total hip arthroplasty (THA) has not been decided. This study was conducted to evaluate the clinical effects of multiple-dose intravenous tranexamic acid (IV-TXA) in THA. One hundred fifty patients were randomized to receive one dose of IV-TXA before incision, followed by 2 doses of IV-TXA (group A), or 3 doses of IV-TXA (group B), or 4 doses of IV-TXA (group C) at 3-hour intervals. The primary outcome was hidden blood loss (HBL). Other outcome measurements such as total blood loss, maximum hemoglobin (Hb) drop, postoperative lowest Hb level, fibrinolysis parameter (D-dimer), inflammatory factor (interleukin-6), transfusion rate, length of stay, and complications were also compared. The mean HBL, total blood loss, and maximum Hb drop were significantly lower in group C than in groups B and A. Such differences were also detected between groups B and A. The postoperative lowest Hb level was significantly higher in group C. D-dimer and interleukin-6 in group C were significantly lower than in groups B and A at 24 and 48 hours postoperatively. Such differences were also significant between groups B and A. There was no significant difference in length of stay among groups. No patient u...Continue Reading

Citations

Jul 28, 2020·Archives of Orthopaedic and Trauma Surgery·Jianlong NiZhibin Shi
Dec 10, 2019·Hip International : the Journal of Clinical and Experimental Research on Hip Pathology and Therapy·Osamu S KimuraMarco Bc Fernandes
Apr 30, 2020·Clinical Spine Surgery : a Spine Publication·Xianren ZhuHongwei Li
Jan 1, 2021·HSS Journal : the Musculoskeletal Journal of Hospital for Special Surgery·Elina HuerfanoAlejandro Gonzalez Della Valle
Apr 14, 2021·Clinical and Applied Thrombosis/hemostasis : Official Journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis·Zhimeng WangLiang Sun
Jun 13, 2021·Journal of Orthopaedic Surgery and Research·Jimin MaQiang Wang

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