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Results for “Tranexamic Acid”

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PubMed2000

[Hemostatic wound management in marcumar patients. Collagen fleece vs. tranexamic acid].

A total of 124 patients on oral anticoagulation therapy with coumarin were treated by orosurgical procedures and entered into a study to determine the hemostatic efficiency of different methods. The therapeutic anticoagulation level was determined in accordance with the recommendations of the American Heart Association (low risk: 2.0 < INR < 3.0; high risk: 2.5 < INR < 3.5) and maintained during treatment. In one group, the alveoli were treated with collagen, in a second group a mouthrinse regime with tranexamic acid was implemented. Twenty-three patients had to be excluded because anticoagulation levels differed from the recommended values. The group treated with collagen included 31 patients, the group with tranexamic acid mouthwashes, 32 patients. A third group was analyzed in which a controlled change in the anticoagulation level had been performed and all treated alveoli had been covered by mucosal flaps (n = 38); they were compared to the other two groups. The surgical proceedings were outlined precisely. Patients treated with collagen had a bleeding rate of 19%, patients with tranexamic acid mouthwash 6%, and those treated with mucosal flaps 40%. The data were not suited for statistical evaluation, they were objected to a descriptive analysis: the confidence intervals were determined by tables for binomial distributions. These did confirm the difference in the frequency of bleeding for the tranexamic acid and mucosal flap groups.

Adult↗

PubMed2000

Reduction of blood loss using tranexamic acid in total knee and hip arthroplasties.

There have been several attempts to reduce postoperative blood loss in patients undergoing total arthroplasty. Benoni et al. reported the usefulness of tranexamic acid in total knee arthroplasty (TKA). We investigated its effect in TKA and total hip arthroplasty (THA). Blood loss was significantly reduced in patients given tranexamic acid in both the TKA and THA groups, and no severe complications, such as venous or pulmonary thrombosis, were noted in any of the patients who received the agent. Administration of tranexamic acid seems to be useful for reducing postoperative blood loss in TKA and THA.

Antifibrinolytic Agents↗

PubMed1980

Influence of tranexamic acid and acetylsalicylic acid on the thickness of the normal cornea.

In a masked cross-over study ten normal subjects were treated with tranexamic acid and acetylsalicylic acid one g three times daily for seven days. The central corneal thickness. was found to increase in response to acetylsalicylic acid and to decrease in response to tranexamic acid. This finding provides evidence for the involvement of the fibrinolytic system in the regulation of the normal corneal thickness. The endothelial morphology, as seen with the specular microscope, was unchanged during treatment with either drug.

Adult↗

PubMed1995

Local antifibrinolytic treatment with tranexamic acid in hemophilic children undergoing dental extractions.

The incidence of post-extraction bleeding and the amount of replacement therapy needed to control bleeding in 24 hemophilic children following the local use of tranexamic acid mouthwash have been investigated. The results of the study showed that 91.6% of patients who used tranexamic acid mouthwash as a supplement to systemic therapy, did not develop post-extraction bleeding; while in 25% of the control patients who received only systemic tranexamic acid, postoperative bleeding was not observed.

Administration, Oral↗

PubMed1977

[Result of an antifibrinolytic treatment using tranexamic acid for the reduction of blood-loss during and after tonsillectomy].

Blood loss during and after tonsillectomy was assessed in 80 patients, 40 of whom were treated with tranexamic acid. A statistically significant reduction of blood loss (28%) was observed in this group during operation. Later bleedings occurred only in 27.5% (control: 67.5%) and stopped after 2 h (mean of control: 5.6h). Bleedings in the tranexamic acid group were mild and scarcely required other hemostyptic treatment, while in the control group some patients had to be treated with etamsylate or fibrogen for a longer period to stop bleeding. Tranexamic acid appears to be an effective and well-tolerated agent for reduction of blood loss caused by local hyperfibrinolysis.

Adolescent↗

PubMed2006

Tranexamic acid reduces postoperative bleeding in off-pump coronary artery bypass grafting.

OBJECTIVE: Tranexamic acid (TA) reduces blood loss in coronary artery surgery with cardiopulmonary bypass. The present prospective study was designed to investigate its hemostatic effect in off-pump coronary artery bypass (OPCAB). METHOD: Seventy-six patients undergoing elective OPCAB were randomized into two groups, received TA (0.75 g loading dose before surgery and 250 mg/h during surgery, gross dose: 1.5 g, n=36) and saline solution (control, n=40), respectively. Perioperative blood samples were collected. Hematochemical parameters including platelet adhesion rate, D-dimer and fibrinopeptide-A (FPA) were analysis. Volume of blood loss, blood transfusion and other clinical data were recorded throughout the perioperative period. RESULTS: Cumulative blood loss was significantly reduced in the TA group as compared to the controls postoperatively (6 hrs (median [25th-75th]): TA: 200.0 [140.0-230.0] ml, CONTROL: 225.0 [200.0-347.5.0] ml, p=0.009; 24 hrs: TA: 440.0 [270.0-605.0] ml, CONTROL: 655.0 [500.0-920.0] ml, p<0.001). Number of patients received blood transfusion in each group was similar. Levels of D-dimer rose significantly after surgery, and were significantly lower in the TA group than that in controls. Platelet adhesion rate and FPA levels remained at baseline levels after the operation in two groups. Early clinical outcomes were similar between groups. CONCLUSION: The results indicated that tranexamic acid limits fibrinolysis and reduces blood loss after off-pump coronary artery bypass surgery.

Aged↗

PubMed1993

Tranexamic acid (Cyklokapron) is not necessary to reduce blood loss after coronary artery bypass operations.

The contribution of fibrinolysis to postoperative bleeding after cardiopulmonary bypass led to routine use of tranexamic acid, a potent antifibrinolytic drug, for a period of time. Two hundred patients undergoing elective coronary artery bypass operations were studied, one group of 100 patients given tranexamic acid (40 mg/kg) (group I) after bypass and one subsequent group of 100 patients (group II) serving as a control group. All patients were treated by the same team, and the groups were comparable in all major clinical parameters. The mean mediastinal drainage in group I was 565 +/- 239 ml versus 656 +/- 257 ml in group II. Univariate and multivariate analysis revealed statistical significance (p = 0.02) when corrected for body surface area. However, applying a consistent blood conservation protocol, including removal of autologous blood before bypass for retransfusion after bypass, returning of all oxygenator and tubing contents to the patients, and autotransfusion of the mediastinal shed blood up to 18 hours postoperatively, resulted in nearly identical hemoglobin concentration at discharge (119 +/- 14 gm/L in group I and 121 +/- 14 gm/L in group II). The prevalence of postoperative myocardial infarction included five patients in group I compared with one patient in group II. Although not statistically significant (p = 0.2), the difference is of concern. Tranexamic acid has a beneficial effect on reducing postoperative bleeding after coronary artery bypass operations. The routine use of the drug is not recommended, however, because its effect is a weak one, and it may be of potential hazard by precipitating thrombosis and eventual myocardial infarction.

Adult↗

PubMed1989

Hemostatic effect of tranexamic acid mouthwash in anticoagulant-treated patients undergoing oral surgery.

We carried out a placebo-controlled, double-blind, randomized study of the hemostatic effect of tranexamic acid mouthwash after oral surgery in 39 patients receiving anticoagulant agents because of the presence of cardiac valvular stenosis, a prosthetic cardiac valve, or a vascular prosthesis. Surgery was performed with no change in the level of anticoagulant therapy, and treatment with the anticoagulant agent was continued after surgery. Before it was sutured, the operative field was irrigated in 19 patients with 10 ml of a 4.8 percent aqueous solution of tranexamic acid (an inhibitor of fibrinolysis) and in 20 patients with a placebo solution. For seven days thereafter, patients were instructed to rinse their mouths with 10 ml of the assigned solution for two minutes four times a day. There were no significant differences between the two treatment groups in base-line variables, including the level of anticoagulation at the time of surgery. Eight patients in the placebo group had a total of 10 postoperative bleeding episodes, whereas only 1 patient in the tranexamic acid group had a bleeding episode (P = 0.01). There were no systemic side effects. We conclude that local antifibrinolytic therapy is effective in preventing bleeding after oral surgery in patients who are being treated with anticoagulants.

Adult↗

PubMed1980

[Possibilities of immunostimulation in oncology. I. In vitro functional activity of rat peritoneal macrophages in presence of tranexamic acid].

Peritoneal macrophages from Wistar rats were examined in vitro to evaluate the effects of tranexamic acid on their spreading activity. The results suggested that some concentrations of the drug (10(-5), 10(-6)) may activate in vitro the function of the peritoneal adherent cells. This finding support the concept that tranexamic acid enhances host resistance by a mechanism to be elucidated.

Adjuvants, Immunologic↗

PubMed1984

Tranexamic acid in the prevention of periventricular haemorrhage.

Increased fibrinolytic activity in the ganglionic eminence of the preterm human brain has been proposed as a factor in the aetiology of periventricular haemorrhage. The effect of tranexamic acid in preventing periventricular haemorrhage was evaluated in 100 infants in a double blind, randomised controlled trial. Haemorrhages developed in 22 infants who received tranexamic acid and in 20 of those who received placebo. A significant reduction in fibrin degradation products in treated infants was seen. Our study suggests that excessive fibrinolytic activity is not an important factor in the aetiology of periventricular haemorrhage and that treatment with tranexamic acid will not prevent its occurrence.

Cerebral Hemorrhage↗

PubMed2006

Effect of topical tranexamic acid in open heart surgery.

BACKGROUND AND OBJECTIVE: Cardiopulmonary bypass is known to induce postoperative coagulopathy including fibrinolysis. We have evaluated the effect of the topical use of tranexamic acid in the pericardial cavity on postoperative bleeding following open heart surgery. METHODS: One hundred patients, scheduled for elective open heart surgery, were included in this double-blind, prospective, randomized, controlled study. They were allocated to a treatment group (Group I), or placebo group (Group II). Patients with coagulopathies, renal failure, re-do surgery, or recent anti-platelet treatment were excluded. In Group I, tranexamic acid (2 g in 100 mL of saline solution) was poured into the pericardial cavity before sternal closure. Placebo patients received 100 mL of saline. Postoperative blood loss, need for transfusion of blood products and the rate of re-sternotomy for bleeding were documented. RESULTS: During the first postoperative 24 h, cumulative blood loss was significantly higher in Group II compared to Group I (1208 +/- 121 mL vs. 733 +/- 93 mL, respectively) (P < 0.001). More blood transfusions were administered to Group II patients (4.54 +/- 1.4 units) as compared to Group I patients (2.64 +/- 1.5 units) (P < 0.01). CONCLUSION: Topical application of tranexamic acid in patients undergoing primary open heart surgery led to a significant reduction of both postoperative mediastinal bleeding, and rate of re-exploration for haemostasis.

Administration, Topical↗

PubMed2006

Tranexamic acid for hemostasis in the surgical treatment of metastatic tumors of the spine.

STUDY DESIGN: This is a retrospective study of sequential cohorts. OBJECTIVE: To assess the efficacy of tranexamic acid in decreasing operative blood loss and the need for intraoperative transfusion in metastatic spine surgery. SUMMARY OF BACKGROUND DATA: Significant published data have established the efficacy of antifibrinolytic drugs in limiting surgical bleeding during heart surgery and total joint replacement. One study in scoliosis suggested benefit in spine surgery as well. METHODS: During a 6-month trial period, 14 patients with spine cancer undergoing palliative intralesional tumor excision and concomitant instrumentation to stabilize the spine in the hands of a single surgeon were administered tranexamic acid intraoperatively in the attempt to minimize operative blood loss. They were then compared to the immediately preceding 14 patients. RESULTS: Estimated operative blood loss was 1385 mL in the study group treated with tranexamic acid and 1815 mL in controls not receiving the drug, and was not found to be significantly decreased in this study. CONCLUSIONS: Control of operative bleeding in metastatic spine surgery can be problematical. Optimum protocol might include routine preoperative angiographic tumor embolization to decrease lesion vascularity in all cases, but angiography is not without risk. Noninvasive prophylaxis of tumor bleeding would have obvious desirable advantages but was, unfortunately, not achieved in this study.

Adult↗

PubMed1995

Hemostatic efficacy of dipyridamole, tranexamic acid, and aprotinin in coronary bypass grafting.

Sixty patients (four groups of 15 patients) were entered in a randomized, controlled study to compare the efficacy of prophylactic treatment with dipyridamole, tranexamic acid, and aprotinin to reduce bleeding after elective coronary artery bypass grafting. Only patients with a preoperative platelet count of less than 246 x 10(9)/L were selected because a previous study showed that these individuals are at risk for increased postoperative bleeding. Compared to control subjects, postoperative blood loss 6 hours after operation was significantly reduced by tranexamic acid (674 +/- 411 versus 352 +/- 150 mL; p < 0.05) and by aprotinin (270 +/- 174 mL; p < 0.01). Dipyridamole did not reduce postoperative blood loss and was associated with complications in 3 patients. We conclude that hemostasis after cardiac operations can be improved with tranexamic acid and aprotinin. Dipyridamole appeared to be ineffective.

Aprotinin↗

PubMed1993

Tranexamic acid as a mouthwash in anticoagulant-treated patients undergoing oral surgery. An alternative method to discontinuing anticoagulant therapy.

A double-blind randomized study was carried out to evaluate the clinical hemostatic effect of tranexamic acid mouthwash after dental extraction in 30 patients who received anticoagulant agents. Surgery was performed with a reduction in the level of anticoagulant therapy in the control group and with no change in the level of anticoagulant therapy in the group who received the tranexamic acid. After the extraction the surgical field was irrigated with a 5% solution of tranexamic acid in the group of 15 patients whose anticoagulant treatment had not been discontinued and with a placebo solution in the group of 15 patients for whom the anticoagulant therapy was reduced. Patients were instructed to rinse their mouths with 10 ml of the assigned solution for 2 minutes four times a day for 7 days. There was no significant difference between the two treatment groups in the bleeding incidence after oral surgery. We conclude that the anticoagulant treatment does not need to be withdrawn before oral surgery provided that local antifibrinolytic therapy is instituted.

Anticoagulants↗

PubMed2004

[Non-histaminic angiodema management: diagnostic and therapeutic interest of tranexamic acid].

INTRODUCTION: The diagnosis of chronic angioedema (localised and reversible oedema) is sometimes very difficult when there is no efficiency of anti-histaminics and corticosteroids. In these cases, bradykinin angioedema must be mentioned. Tranexamic acid is efficient and must be proposed. STUDY: We reported seven patients who have a non-histaminergic angioedema since an average of 8 years. Corticosteroids and histamine-1 blockers were not efficient. Daily tranexamic acid treatment (1 g x 3 per day) controlled the disease. Three patients had no more attack. The C1Inh antigen and function levels were normal. No secondary effect was described and all patients are still being treated (average of 20 months). CONCLUSION: When a non-histaminergic angioedema is suspected, tranexamic acid must be proposed as attack's treatment and as prophylactic treatment.

Adolescent↗

PubMed1984

Wound healing following dental extractions in rabbits: effects of tranexamic acid, warfarin anti-coagulation, and socket packing.

We have investigated the importance of the coagulation and fibrinolytic systems for wound healing following dental extractions. Four front teeth were extracted in rabbits; wound healing was measured as time until complete epithelial closure. The antifibrinolytic agent tranexamic acid shortened duration of wound healing in normal rabbits. Anti-coagulation with warfarin delayed epithelial closure, which was, however, normalized by simultaneous administration of tranexamic acid, whereas complete packing of the socket with oxidized cellulose had no corrective effect. Apical packing together with tranexamic acid gave normal healing. It is concluded that the quality of the fibrin network within the dental socket determines the rate of wound healing; oxidized cellulose is not an adequate substitute for fibrin.

Alveolar Process↗

PubMed1981

Effect of tranexamic acid on the growth and metastasis of V2 carcinoma in rabbits.

The antifibrinolytic action of tranexamic acid (AMCHA) on the growth and metastasis of rabbit V2 carcinoma having high fibrinolytic activity was studied. Upon oral administration of AMCHA, the growth of the tumor and metastasis to the lung tended to be inhibited, and the number of metastatic foci in the regional lymph nodes significantly decreased in the early period of tumor growth. Enhancement of fibrin deposition in the tumor and inhibition of fibrinolytic activity of the tumor were recognized in the AMCHA-treated group. The inhibitory effect of tranexamic acid on fibrin dissolution might interfere with local tumor growth and the release of tumor cells into the vessels.

Animals↗

PubMed1990

Fibrinolytic activity after subarachnoid haemorrhage and the effect of tranexamic acid.

Seventy-four patients with recent subarachnoid haemorrhage were randomly allocated to placebo or tranexamic acid treatment. Fibrinolytic activity in the blood and cerebrospinal fluid was assessed before treatment, one week later and two weeks later. The natural history of fibrinolysis following subarachnoid haemorrhage was obtained from analysis of the placebo group. Following subarachnoid haemorrhage, fibrin degradation products and plasminogen activity in the cerebrospinal fluid were elevated. Subsequently, fibrin degradation products in the cerebrospinal fluid fell progressively over the following 2 weeks. Changes in cerebrospinal fluid plasminogen activity correlated with those of blood plasminogen activity. Complications such as rebleeding, hydrocephalus or cerebral thrombosis could not be predicted from analysis of fibrinolytic activity. Tranexamic acid treatment resulted in a reduction in cerebrospinal fluid and blood plasminogen activity. The relevance of fibrinolysis in cerebrospinal fluid and blood to the management of subarachnoid haemorrhage is discussed.

Antifibrinolytic Agents↗