Is tranexamic acid appropriate for all patients undergoing high-risk surgery?

IF 3.5 3区医学 Q1 CRITICAL CARE MEDICINE

Current Opinion in Critical Care Pub Date : 2024-12-01 Epub Date: 2024-09-07 DOI:10.1097/MCC.0000000000001207

Ane Abad-Motos, Jose A García-Erce, Paolo Gresele, Jose A Páramo

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引用次数: 0

Abstract

Purpose of review: Tranexamic acid (TXA), an antifibrinolytic agent, reduces surgical bleeding in a variety of procedures, such as cardiac, orthopedic, abdominal, and urologic surgery, cesarean section, and neurosurgery. However, there are surgical interventions for which its use is not yet widespread, and some caution persists because of concerns regarding thrombotic risk. The purpose of this review is to analyze the most recent evidence in various subgroups of surgical specialties and the association of TXA with thrombotic events and other side effects (e.g. seizures).

Recent findings: Recent clinical trials and meta-analyses have shown that the efficacy and safety vary according to the clinical context, timing of administration, and dose. Some reports found that TXA reduces major bleeding by 25% without a significant increase in thrombotic events.

Summary: Wider use of TXA has the potential to improve surgical safety, avoid unnecessary blood use, and save healthcare funds.

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氨甲环酸是否适用于所有接受高风险手术的患者？

审查目的：氨甲环酸（TXA）是一种抗纤维蛋白溶解剂，可减少心脏、骨科、腹部和泌尿科手术、剖腹产和神经外科等多种手术中的出血。然而，在一些外科手术中，这种药物的应用还不广泛，而且由于担心血栓形成的风险，人们仍持谨慎态度。本综述旨在分析外科各专科亚组的最新证据，以及 TXA 与血栓事件和其他副作用（如癫痫发作）的关系：最近的临床试验和荟萃分析表明，疗效和安全性因临床环境、给药时间和剂量而异。摘要：广泛使用 TXA 有可能提高手术安全性，避免不必要的用血，节省医疗资金。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Current Opinion in Critical Care 医学-危重病医学

CiteScore

5.90

自引率

3.00%

发文量

172

审稿时长

6-12 weeks

期刊介绍： Current Opinion in Critical Care delivers a broad-based perspective on the most recent and most exciting developments in critical care from across the world. Published bimonthly and featuring thirteen key topics – including the respiratory system, neuroscience, trauma and infectious diseases – the journal’s renowned team of guest editors ensure a balanced, expert assessment of the recently published literature in each respective field with insightful editorials and on-the-mark invited reviews.