The role of Tranexamic acid in the Reduction of Bleeding in Abdominal Aortic Aneurysm Surgery
DOI:
https://doi.org/10.51253/pafmj.v73i6.7689Keywords:
Aneurysm, Bleeding, Blood transfusion, FibrinAbstract
Objective: To determine the effects of Tranexamic acid on intraoperative blood loss.
Study Design: Quasi-experimental study.
Place and Duration of Study: Combined Military Hospital, Rawalpindi Pakistan, from Jun to Oct 2021.
Methodology: A total of 96 patients from both genders undergoing elective open abdominal aortic aneurysm surgery under general anaesthesia enrolled in the study after random distribution to Drug and Control Groups. The primary determinant was intraoperative blood loss. Additionally, determining variables were intraoperative and postoperative blood transfusions, thromboembolic episodes, and postoperative mortality rate.
Results: A total of 96 patients enrolled in the study, out of which 90(93%) were males, whereas 6(7%) were females, with a
mean age of 65.37±7.01 (55–75 years). Of 96 participants, 52(54%) patients were from ASA Class II and 44(46%) were from ASA Class III. There was no significant correlation between surgical time (p-value 0.45), clamping time (p-value 0.34), and
intraoperative and postoperative transfusions (p-value 0.56 and 0.28, respectively). However, a statistically significant
reduction in intraoperative and postoperative blood loss was recorded (p-value <0.001).
Conclusion: Tranexamic acid significantly impacts the reduction of intraoperative and postoperative bleeding in elective open abdominal aortic aneurysm surgeries under general anaesthesia.
Downloads
Metrics
References
Halt-It Trial Collaborators. Effects of a high-dose 24-h infusion of tranexamic acid on death and thromboembolic events in patients with acute gastrointestinal bleeding (HALT-IT): an international randomized, double-blind, placebo-controlled trial. Lancet 2020; 395(10241): 1927-1936. https://doi.org/10.1016/s0140-6736(20)30848-5.
Goobie SM, Zurakowski D, Glotzbecker MP, McCann ME, Hedequist D, Brustowicz RM, et al. Tranexamic Acid Is
Efficacious at Decreasing the Rate of Blood Loss in Adolescent Scoliosis Surgery: A Randomized Placebo-Controlled Trial. J
Bone Joint Surg Am 2018; 100(23): 2024-2032. https://doi.org/10.2106/jbjs.18.00314.
Zufferey PJ, Lanoiselée J, Chapelle C, Borisov DB, Bien JY, Lambert P, et al. Intravenous Tranexamic Acid Bolus plus
Infusion Is Not More Effective than a Single Bolus in Primary Hip Arthroplasty: A Randomized Controlled Trial.
Anesthesiology 2017; 127(3): 413-422. https://doi.org/10.1097/aln.0000000000001787.
Zhang Y, Jia Y, Shi J, Yuan S, Wang R, Zhang Z, et al. Safety and efficacy of tranexamic acid in pediatric cardiac surgery: study protocol for a double-blind randomized controlled trial. BMJ
Open 2019; 9(11): e032642.https://doi.org/10.1136%2Fbmjopen-2019-032642.
Mebel D, Akagami R, Flexman AM. Use of Tranexamic Acid IsAssociated with Reduced Blood Product Transfusion in ComplexSkull Base Neurosurgical Procedures: A Retrospective CohortStudy. Anesth Analg 2016; 122(2): 503-508.
https://doi.org/10.1213/ane.0000000000001065.
Myles PS, Smith JA, Forbes A, Silbert B, Jayarajah M, Painter T, etal. Tranexamic Acid in Patients Undergoing Coronary-ArterySurgery. N Engl J Med 2017; 376(2): 136-148.https://doi.org/10.1056/nejmoa1606424.
Colomina MJ, Koo M, Basora M, Pizones J, Mora L, Bagó J.Intraoperative tranexamic acid use in major spine surgery in
adults: a multicentre, randomized, placebo-controlled trial. Br JAnaesth 2017; 118(3): 380-390.https://doi.org/10.1093/BJA/aew434.
Alaifan T, Alenazy A, Xiang-Wang D, Fernando SM, Spence J,Belley CE, et al. Tranexamic acid in cardiac surgery: a systematicreview and meta-analysis (protocol). BMJ Open 2019; 9(9):e028585. https://doi.org/10.1136/bmjopen-2018-028585.
Mufarrih SH, Malik AT, Qureshi NQ, Lakdawala RH, RabbaniMU, Ali A, et al. The effect of tranexamic acid in unilateral and
bilateral total knee arthroplasty in the South Asian population: Aretrospective cohort study. Int J Surg 2018; 52(1): 25-29.
https://doi.org/10.1016/j.ijsu.2018.02.005.
Breau RH, Lavallée LT, Cnossen S, Witiuk K, Cagiannos I,Momoli F, et al. Tranexamic Acid versus Placebo to Prevent
Blood Transfusion during Radical Cystectomy for BladderCancer (TACT): Study Protocol for a Randomized Controlled
Trial. Trials 2018; 19(1): 261.https://doi.org/10.1186/s13063-018-2626-3.
Gianfagna F, Veronesi G, Bertù L, Tozzi M, Tarallo A, FerrarioMM, et al. Prevalence of abdominal aortic aneurysms and its
relation with cardiovascular risk stratification: protocol of theRisk of Cardiovascular diseases and abdominal aortic Aneurysm
in Varese (RoCAV) population-based study. BMC CardiovascDisord 2016; 16(1): 243.
https://doi.org/10.1186/s12872-016-0420-2.
Kietpeerakool C, Supoken A, Laopaiboon M, Lumbiganon P.Effectiveness of tranexamic acid in reducing blood loss duringcytoreductive surgery for advanced ovarian cancer. CochraneDatabase Syst Rev 2016; 2016(1): CD011732.
https://doi.org/10.1002/14651858.cd011732.pub2.
Roberts I, Shakur H, Coats T, Hunt B, Balogun E, Barnetson L, etal. The CRASH-2 trial: a randomized controlled trial and
economic evaluation of the effects of tranexamic acid on death,vascular occlusive events and transfusion requirement in
bleeding trauma patients. Health Technol Assess 2013; 17(10): 1-79. https://doi.org/10.3310/hta17100.
Monaco F, Nardelli P, Pasin L, Barucco G, Mattioli C, DiTomasso N, et al. Tranexamic acid in open aortic aneurysm
surgery: a randomized clinical trial. Br J Anaesth 2020; 124(1): 35-43. https://doi.org/10.1016/j.bja.2019.08.028.
Obi AT, Park YJ, Bove P.The association of perioperativetransfusion with 30-day morbidity and mortality in patients
undergoing major vascular surgery. J Vasc Surg 2015; 61(2): 1000-1009. https://doi.org/10.1016/j.jvs.2014.10.106.
Osborne Z, Hanson K, Brooke BS. Variation in transfusionpractices and the association with perioperative adverse events
in patients undergoing open abdominal aortic aneurysm repairand lower extremity arterial bypass in the vascular quality
initiative. Ann Vasc Surg 2018; 46(1): 1-16.https://doi.org/10.1016/j.avsg.2017.06.154.
Fenger EC, D'Amore LA, Nørholt SE, Von OG, Tarpgaard M.Reduced perioperative blood loss in children undergoing
craniosynostosis surgery using prolonged tranexamic acidinfusion: a randomized trial. Br J Anaesth 2019; 122(6): 760-766.https://doi.org/10.1016/j.bja.2019.02.017.
Topsoee MF, Bergholt T, Ravn P, Schouenborg L, Moeller C,Ottesen B, et al. Anti-hemorrhagic effect of prophylactic
tranexamic acid in a benign hysterectomy-a double-blindedrandomized placebo-controlled trial. Am J Obstet Gynecol 2016;
(1): 72-78. https://doi.org/10.1016/j.ajog.2016.01.184.
Downloads
Published
How to Cite
Issue
Section
