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Results for “Tranexamic Acid”

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At least 217 records · Page 12Linked to original sources

PubMed2003

Tranexamic acid mouthwash versus autologous fibrin glue in patients taking warfarin undergoing dental extractions: a randomized prospective clinical study.

PURPOSE: The aim of this prospective study was to compare the effectiveness of a 4.8% tranexamic acid mouthwash versus an autologous fibrin glue preparation to control hemostasis in patients therapeutically anticoagulated with warfarin who required dental extractions without interruption of their treatment. PATIENTS AND METHODS: The 49 patients who underwent 152 dental extractions were randomly allocated to 2 groups: Group A were required to rinse with 10 mL of a 4.8% tranexamic acid solution 4 times a day for 7 days postoperatively. Group B received autologous fibrin glue intraoperatively. The international normalized ratio was measured on the day of the procedure. All procedures were performed on an ambulatory basis by the same surgeon. RESULTS: Of the 49 patients, 2 presented with postoperative bleeding (4%). Both patients were from the autologous fibrin glue group and were found to have grossly elevated international normalized ratios on the day of the bleeding that was unaccounted for. CONCLUSIONS: This study supports the consensus that dental extractions can be performed without modification of oral anticoagulant treatment. Local hemostasis with an absorbable oxidized cellulose mesh, tranexamic acid, and sutures is the more cost efficient of the 2 methods compared; however, autologous fibrin glue has an important role in patients unable to use a mouthwash effectively.

Adult↗

PubMed1978

The effect of tranexamic acid on the fibrinolytic activity of vein walls.

16 patients were treated with the fibrinolytic inhibitor tranexamic acid in an initial i.v. dose of 1 g followed by an oral dose of 4 g a day for one week and 3 g a day for two weeks. Biopsy specimens of superficial veins were obtained before and on the last day of treatment and examined histochemically for their fibrinolytic activity. Tranexamic acid did not suppress the fibrinolytic activity in the vessel walls, which is the most important link in the fibrinolytic defence system against thrombosis.

Administration, Oral↗

PubMed2003

Tranexamic acid mouthwash--a prospective randomized study of a 2-day regimen vs 5-day regimen to prevent postoperative bleeding in anticoagulated patients requiring dental extractions.

This prospective randomized study analyses the use of a prescribed 4.8% tranexamic acid post-operative mouthwash over 2 days vs 5 days to prevent bleeding in patients taking warfarin who require dental extractions. Eighty-five patients therapeutically anticoagulated with warfarin for various conditions, ranging in age from 21 to 86 years and requiring dental extractions, were randomly divided into two groups. Group A postoperatively received a 4.8% tranexamic acid mouthwash to be used over a 2-day period. Group B received the same mouthwash and instructions postoperatively, to be taken over 5 days. All procedures were performed on an ambulatory basis under local anaesthetic by the same surgeon. Patients were reviewed 1, 3, and 7 days postoperatively to assess bleeding. Eighty-two of the 85 patients encountered no postoperative problems. Two patients in group A and one in group B had minor postoperative bleeds that required minor ambulatory intervention to control. This study shows that a 2-day postoperative course of a 4.8% tranexamic acid mouthwash is as equally effective as a 5-day course in controlling haemostasis post-dental extractions in patient's anticoagulated with warfarin.

Administration, Topical↗

PubMed1993

[Treatment of menorrhagia with tranexamic acid. A clinical trial of an underestimated problem in general practice].

44 women with heavy menstrual bleeding participated in a six months randomised, double blind, cross over clinical trial. The objective was to use simple methods to study whether treatment of menorrhagia with tranexamic acid has an effect that can be detected by the women themselves. The effect was evaluated by means of diaries and a visual analog scale. The bleeding during each period of treatment was compared with the bleeding during untreated periods. Bleeding during the different periods of treatment was also compared directly. The results indicate that tranexamic acid was more effective than placebo. This difference was not disclosed, however, in the laboratory data. After the study, 75% of the women wished to continue treatment with tranexamic acid.

Adult↗

PubMed1981

Tranexamic acid in the prevention of secondary haemorrhage after traumatic hyphaema.

The occurrence of secondary haemorrhage after traumatic hyphaema was studied in 239 patients treated in the Department of Ophthalmology, Tampere Central Hospital during the years 1972 to 1980. From 1972 to 1976, 126 patients with traumatic hyphaema were confined to bed and treated without antifibrinolytic agents; nine (7.1%) of these patients developed secondary haemorrhage. From 1977 to 1980, none of 58 patients with traumatic hyphema treated with tranexamic acid developed secondary haemorrhage which was seen in 3 (5.5%) of 55 patients treated without antifibrinolytic agents; the activities of these patients were not restricted and the eyes were not patched. The resorption of the hyphaema was significantly delayed in the tranexamic acid treated patients. It is concluded that tranexamic acid delays resorption of the blood-clot sealing the damaged vessel and preventing secondary haemorrhage after traumatic hyphaema without bed-rest and binocular patching.

Adolescent↗

PubMed2003

Tranexamic acid reduces blood loss and blood transfusions in primary total hip arthroplasty: a prospective randomized double-blind study in 40 patients.

INTRODUCTION: We performed a prospective, randomized, double-blind study on 40 patients scheduled for primary total hip arthroplasty due to arthrosis or osteonecrosis to determine the effect of tranexamic acid on per- and postoperative blood losses and on the number of blood transfusions needed. PATIENTS AND METHODS: 40 patients were randomized to tranexamic acid (10 mg/kg given as a bolus intravenous injection, followed by a continuous infusion of 1 mg/kg/hour for 10 hours) or placebo (20 mL saline given intravenously) 15 minutes before the incision. We recorded the peroperative and postoperative blood losses at removal of the drain 24 hours after the operation and the number of blood transfusions. RESULTS: Patients receiving tranexamic acid had a mean peroperative blood loss of 480 mL versus 622 mL in patients receiving placebo (p = 0.3), a postoperative blood loss of 334 mL versus 609 mL (p = 0.001), a total blood loss of 814 mL versus 1231 mL (p = 0.001) and a total need for 4 blood transfusions versus 25 (p = 0.04). No patient in either group had symptoms of deep venous thrombosis, pulmonary embolism or prolonged wound drainage. INTERPRETATION: Transemic acid is effective in reducing the postoperative blood loss, the total blood loss and the need for blood transfusion in primary total hip arthroplasty.

Aged↗

PubMed1984

Lack of effect of tranexamic acid on rheumatoid arthritis.

In a double-blind controlled study on 45 rheumatoid arthritis patients, no effect of tranexamic acid (Cyklocapron, 4.5 g per day for 6 weeks) was found in terms of subjective or objective parameters of disease activity. Tranexamic acid did not reduce complement activation, measured by plasma concentrations of the complement C3 split product C3d. Immune complex concentrations in serum were also unaffected. We conclude that plasmin inhibitors do not reduce immune complex mediated complement activation, and they should not be used for treatment of rheumatoid arthritis.

Adult↗

PubMed1987

Establishment of a human ovarian cancer cell line capable of forming ascites in nude mice and effects of tranexamic acid on cell proliferation and ascites formation.

The present study was designed to obtain an experimental tumor model as similar as possible to human ovarian cancer which often had a large amount of ascites and to assess the therapeutic value of tranexamic acid. Human tumor cell lines which form ascites in nude mice were established from ascites of patient with serous cystadenocarcinoma of the ovary. Two cloned cell lines designated HRA and HR-1 were obtained from the parent cell line designated HR. All of these cultured cell lines had about 2.5-3.5 times higher lactate dehydrogenase activities than the original tumor. The original tumor and the tumor grown in nude mice had all 5 bands of lactate dehydrogenase isoenzymes, while all cultured cell lines had only a marked lactate dehydrogenase-3 in addition to a faint lactate dehydrogenase-2. Modal chromosome numbers of HR cells ranged from 50-76, while that of HRA cells ranged widely from 40-140. The DNA histograms of HR and HRA cells were similar to each other, showing predominant G1 and S phases. Although these cell lines had ability to produce ascites in the nude mice when the cells were inoculated i.p., the HRA cell inoculation made ascites most rapidly and brought about the shortest median survival (39 days). The proliferations of all three cell lines were dose-dependently inhibited by tranexamic acid. However, the concentration of this drug required for 50% inhibition of the proliferation of HRA cells was about one-half of that of HR and HR-1 cells. In addition, i.p. injections of tranexamic acid to nude mice treated with cisplatin resulted in a significant inhibition of the ascites formation and prolongation of 50% survival.

Animals↗

PubMed2005

Effectiveness in controlling haemorrhage after dental scaling in people with haemophilia by using tranexamic acid mouthwash.

AIMS: To compare the effectiveness of tranexamic acid mouthwash (TAMW) in controlling gingival haemorrhage after dental scaling with that of using factor replacement therapy (FRT) prior to dental scaling in people with haemophilia. DESIGN: Double-blind cross-over randomised control trial. SETTING: Dedicated hospital dental practice for patients with inherited bleeding disorders. METHOD: Sixteen patients with haemophilia who required dental scaling participated in this pilot study. The experimental treatment regime (ETR) involved transfusing each patient with saline before scaling both quadrants on one side of the mouth followed by oral rinsing with TAMW four times daily for up to eight days. The control regime (CR) involved giving each patient FRT before scaling the opposite side of the mouth followed by use of a placebo TAMW. Each patient underwent both treatments in a random-ised sequence. Both the operator and the patients were unaware of which were the ETR and CR episodes. On both occasions the patient kept a log book of the rinsing regime and any post-operative bleeding. Additionally, a structured post-treatment telephone interview was conducted to assess the effectiveness and the patient acceptability of the ETR. RESULTS: Thirteen patients completed the study. No statistically significant difference was found in gingival bleeding and mouthwashing frequencies between the ETR and the CR (p > 0.05). Five patients reported no gingival bleeding with either the ETR or the CR. No patient, using either regime, required extra FRT due to gingival haemorrhage. All subjects found the ETR acceptable and easy and reported feeling safe in using TAMW alone to control gingival bleeding after dental scaling. CONCLUSION: TAMW use after dental scaling was as effective as using FRT beforehand in controlling gingival haemorrhage for people with haemophilia.

Adolescent↗

PubMed1995

[Comparison of effects of aprotinin and tranexamic acid on blood loss in heart surgery].

OBJECTIVES: To compare the efficacy of aprotinin (APR) and tranexamic acid (TRA) in reducing blood loss and transfusion requirements after cardiac surgery under extracorporeal circulation (ECC). STUDY DESIGN: Randomized controlled trial. PATIENTS: One hundred and four adults undergoing either coronary artery bypass grafting (CABG) (n = 55), or aortic valve replacement (AVR) (n = 49), allocated into three groups. METHODS: a) APR group (23 CABG and 20 AVR) received aprotinin, 2 x 10(6) KIU (280 mg) after induction, followed by an infusion of 0.5 x 106 KIU.h-1 (70 mg.h-1) until chest closure, with a supplement to the oxygenator prime of 2 x 10(6) KIU; b) TRA group (22 CABG and 19 AVR) received tranexamic acid, 15 mg.kg-1 between the injection of heparin (400 IU.kg-1) and the beginning of ECC, 15 mg.kg-1 after protamin injection (1.3 mg/100 IU of heparin); c) CTR group (10 CABG and 10 AVR), the control group, was not treated with an antifibrinolytic agent. The amount of blood collected from the chest tube drainage was measured at admission to ICU, as well as 4, 8 and 18 h after the insertion of drains and at the time of their removal. Packed red cells where given when the haematocrit was under 20% during ECC, 25% at the end of surgery and 30% after extubation. RESULTS: The blood loss was lower in APR group (834 +/- 448 mL) than in TRA group (1015 +/- 409 mL) (P = 0.009), and in CTR group (1416 +/- 559 ML) (P = 0.004). The rates of transfused patients in groups APR, ATR and CTR were 35, 37 and 60% respectively and the numbers of units administered per patient were 0.8, 0.8 and 1.7 respectively. In AVR cases, APR and TRA had a similar efficacy. In CABG cases, only aprotinin decreased postoperative bleeding. However there was no difference between APR and TRA concerning the transfusion requirements. In CABG cases the ECC was of shorter duration and blood loss was 1127 +/- 540 mL vs 894 +/- 422 mL in AVR cases (P = 0.03). CONCLUSIONS: Both APR and TRA decrease blood loss. APR is more efficient after CABG than TRA as far as blood loss is concerned, whereas the transfusion requirements are similar. As APR is about 100 times more expensive and carries a risk for allergic reactions, its use in a high dose regimen is only recommended for reoperations, in patients treated with salicylates and in case of sepsis.

Adult↗

PubMed1989

Tranexamic acid in the treatment of Kasabach-Merritt syndrome in infants.

Kasabach-Merritt syndrome (thrombocytopenia, consumption coagulopathy, and, occasionally, microangiopathic hemolysis) is an infrequent but often lethal complication of giant capillary hemangiomas in the infant. We report the clinical course of an infant who came to us with this syndrome shortly after birth. She was successfully treated with transfusions of blood products, high-dose oral prednisone, and a fibrinolytic inhibitor, tranexamic acid. No complications of the treatment occurred. The hematological abnormalities resolved completely by 2 years of age. Although prednisone may have been necessary for stabilization and involution of the hemangioma, the addition of tranexamic acid allowed earlier tapering of the steroid therapy and fewer transfusions. Tranexamic acid was extremely well tolerated in this newborn.

Cyclohexanecarboxylic Acids↗

PubMed2004

Inhibition of plasmin activity by tranexamic acid does not influence inflammatory pathways during human endotoxemia.

OBJECTIVE: Plasmin activates several proinflammatory pathways at the cellular level in vitro. Lipopolysaccharide (LPS) administration to healthy humans results in a rapid generation of plasmin activity, accompanied by activation of a number of inflammatory systems. METHODS AND RESULTS: To determine the role of early plasmin activity in LPS-induced inflammation in vivo, 16 healthy males received an intravenous bolus injection with LPS (from Escherichia coli, 4 ng/kg) directly preceded by a 30-minute intravenous infusion of tranexamic acid (2 g, n=8), a plasmin activation inhibitor, or placebo (n=8). LPS injection induced marked increases in the plasma levels of D-dimer and plasmin-alpha2-antiplasmin complexes, indicative of plasmin activation and generation, respectively, which were strongly attenuated by tranexamic acid (both P<0.01 versus placebo). However, tranexamic acid did not influence LPS-induced coagulation activation, granulocytosis, neutrophil activation (expression of CD11b, CD66b, and L-selectin) or degranulation (plasma concentrations of elastase-alpha1-antitrypsin and bactericidal permeability-increasing protein), endothelial cell activation (plasma levels of von Willebrand factor and soluble E-selectin), or cytokine release. CONCLUSIONS: These data argue against a role of early plasmin generation in the subsequent activation of other inflammatory pathways during human endotoxemia.

Adult↗

PubMed1997

The effect of tranexamic acid on local and plasma fibrinolysis during total knee arthroplasty.

The aim of the present study was to investigate aspects of coagulation and fibrinolysis during knee arthroplasties in order to find out. 1. whether an increased fibrinolysis is correlated to an increased blood loss 2. whether there is a difference in markers for coagulation and fibrinolysis in peripheral venous blood compared to those in blood from the wounds 3. whether the administration of tranexamic acid modifies the fibrinolytic response. Twenty-four patients were included. Twelve patients were given tranexamic acid intravenously at the end of the operation. The dose was repeated three hours later. The other 12 patients were given an equivalent amount of placebo. The administration was randomised and double-blind. Levels of prothrombin fragments 1 + 2, D-dimers, plasminogen, alpha 2-antiplasmin, tissue plasminogen activator (tPA), and plasminogen activator inhibitor (PAI-1) in venous blood were investigated just before the operation, at the end of the operation and three hours later. At the end of the operation blood for analysis was also drawn from the wound. Coagulation and fibrinolysis was activated during and after surgery. The activation was significantly higher in blood from the wounds than in peripheral venous blood. We found no direct correlation between the degree of fibrinolysis and blood loss. The administration of tranexamic acid reduced fibrinolysis in the wounds but not in peripheral venous blood. The postoperative blood loss was reduced by half.

Aged↗

PubMed1995

The use of tranexamic acid to reduce postoperative bleeding following cardiac surgery: a double-blind randomized trial.

Bleeding during the first 24 hours following cardiac surgery using cardio-pulmonary bypass (CPB) is a serious complication. Attempts to modify the degree of postoperative bleeding with pharmacologic therapy have met with limited success. Tranexamic acid, a potent inhibitor of plasminogen, may decrease the amount of mediastinal bleeding following surgery utilizing CPB. We assigned 30 patients who were about to undergo cardiac surgery to a double-blind randomized trial. The treatment group received tranexamic acid, given intravenously as 10 mg/kg over 30 minutes, at the time of skin incision, followed by a 1 mg/kg/hr infusion for 12 hours. The control group received a placebo (saline) of equal volume. Measurements of shed mediastinal blood and transfused homologous blood were made at 6, 12, and 24 hours postoperatively. Mediastinal blood loss in the treatment and control groups was 382 mL versus 594 mL at 6 hours (P = 0.08), 502 mL versus 848 mL at 12 hours (P = 0.04), and 711 mL versus 1160 mL at 24 hours (P = 0.02). The mean transfusion volumes after 24 hours were 356 mL in the treatment group and 528 mL in the placebo group (P = NS). Prophylactic tranexamic acid infusion decreases mediastinal blood loss following cardiopulmonary assisted cardiac surgery.

Blood Transfusion↗

PubMed1988

Menstruation-related angioedema treated with tranexamic acid.

A case of menstruation-related angioedema is presented. The symptoms observed were cyclically appearing hoarseness due to laryngeal edema without any pain. Symptoms disappeared during intake of contraceptive pills and during pregnancy with recurrence at the onset of menstruation post partum. A therapeutic trial with tranexamic acid was successful. The use of tranexamic acid in secondary and idiopathic angioedema should be considered.

Adult↗

PubMedDate not supplied

Effect of local tranexamic acid gel in the treatment of epistaxis.

In patients with nosebleedings, the hemostatic effect of local application of tranexamic acid gel or placebo was compared in a randomized, double-blind, multicenter clinical trial with parallel groups. The times needed to arrest the initial bleeding were recorded, as well as any rebleedings within 10 days. The results showed no significant differences in any of the efficacy variables. Tranexamic acid was no better than placebo in the early treatment of nose bleedings, but the gel itself seemed to have a beneficial effect. The gel preparations were easy to insert into the nasal cavity and caused no discomfort to the patients.

Adult↗

PubMed1976

Tranexamic acid (AMCA) and late hyphaema. A double blind study in cataract surgery.

A double blind study of the effect of tranexamic acid (AMCA) on late hyphaema after cataract surgery is reported. A total of 244 patients were included in the study after strict selection. It was shown that the incidence of late hyphaema in the treated group was significantly lower at the 5% level than that in the placebo group. The conclusion is made that the fibrinolytic inhibitor tranexamic acid can be used therapeutically or prophylactically to decrease the risk for re-bleeding after ocular surgery.

Administration, Oral↗

PubMed2006

["Ultra-early" antifibrinolytic treatment of subarachnoidal bleeding with tranexamic acid].

Rebleeding is the biggest risk for patients suffering from subarachnoidal bleeding (SAH) from a ruptured aneurysm, and many resources are spent on early diagnosis and closure of the aneurysm with clip or coils. Recent studies have indicated that the risk of rebleeding is significantly greater in the initial six hours after the first bleeding, i.e., prior to possible closure of the aneurysm. A new prospective randomised study from Sweden indicates that antifibrinolytic treatment with tranexamic acid reduced the incidence of these ultra-early rebleedings from 10.8% to 2.4% and that almost all of this effect was obtained within the first few hours after primary hospital admission. Tranexamic acid treatment was without side effects and was given in standard doses until closure of the aneurysm or alternatively up to three days after the initial bleeding. Naturally, this new treatment has focused on the ultra-early phase of the SAH disease with its enforced acute hospitalization for nonpostponable diagnosis and tranexamic acid treatment. Its implementation is a task for neurosurgical departments in collaboration with regional hospitals and the primary sector.

Aneurysm, Ruptured↗