Journal
CURRENT OPINION IN ANESTHESIOLOGY
Volume 28, Issue 2, Pages 191-200Publisher
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/ACO.0000000000000165
Keywords
fibrinolysis; perioperative; thromboembolism; tranexamic acid; transfusion
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Funding
- NIH [R01 GM086416]
- NATIONAL INSTITUTE OF GENERAL MEDICAL SCIENCES [R01GM086416] Funding Source: NIH RePORTER
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Purpose of review Optimizing hemostasis with antifibrinolytics is becoming a common surgical practice. Large clinical studies have demonstrated efficacy and safety of tranexamic acid (TXA) in the trauma population to reduce blood loss and transfusions. Its use in patients without pre-existing coagulopathies is debated, as thromboembolic events are a concern. In this review, perioperative administration of TXA is examined in nontrauma surgical populations. Additionally, risk of thromboembolism, dosing regimens, and timing of dosing are assessed. Recent findings Perioperative use of TXA is associated with reduced blood loss and transfusions. Thromboembolic effects do not appear to be increased. However, optimal dosing and timing of TXA administration is still under investigation for nontrauma surgical populations. Summary As part of a perioperative blood management programme, TXA can be used to help reduce blood loss and mitigate exposure to blood transfusion.
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