{"title":"Application of high-dose tranexamic acid in the perioperative period: a narrative review.","authors":"Yushan Duan, Xiaohong Wan, Yiming Ma, Weihua Zhu, Yue Yin, Qingqing Huang, Yuan Yang","doi":"10.3389/fphar.2025.1552511","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>To investigate the efficacy and safety of high-dose tranexamic acid in different types of surgeries and provide a reference for clinical practice.</p><p><strong>Methods: </strong>We systematically searched PubMed, Cochrane Library, Science, Embase, and CNKI databases, from their inception to January 2025, to include representative literature related to high-dose tranexamic acid in the perioperative period for a thematic synthesis. The analysis focused on clinical evidence related to obstetric, cardiac, urologic, orthopedic, and spinal surgeries.</p><p><strong>Results: </strong>High-dose tranexamic acid markedly reduces blood loss and transfusion requirements in most types of surgery; however, the optimal dose varies by surgery type. Available studies have shown a favorable safety profile; however, some areas (e.g., cardiac surgery) still require careful monitoring for seizures and risk of thrombotic events.</p><p><strong>Conclusion: </strong>The clinical benefit of high-dose tranexamic acid should be assessed based on surgical characteristics and patient individualization. More multicenter studies are needed to clarify the dose-effect relationship and long-term safety.</p>","PeriodicalId":12491,"journal":{"name":"Frontiers in Pharmacology","volume":"16 ","pages":"1552511"},"PeriodicalIF":4.4000,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11968675/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Frontiers in Pharmacology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.3389/fphar.2025.1552511","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"Q1","JCRName":"PHARMACOLOGY & PHARMACY","Score":null,"Total":0}
引用次数: 0
Abstract
Objective: To investigate the efficacy and safety of high-dose tranexamic acid in different types of surgeries and provide a reference for clinical practice.
Methods: We systematically searched PubMed, Cochrane Library, Science, Embase, and CNKI databases, from their inception to January 2025, to include representative literature related to high-dose tranexamic acid in the perioperative period for a thematic synthesis. The analysis focused on clinical evidence related to obstetric, cardiac, urologic, orthopedic, and spinal surgeries.
Results: High-dose tranexamic acid markedly reduces blood loss and transfusion requirements in most types of surgery; however, the optimal dose varies by surgery type. Available studies have shown a favorable safety profile; however, some areas (e.g., cardiac surgery) still require careful monitoring for seizures and risk of thrombotic events.
Conclusion: The clinical benefit of high-dose tranexamic acid should be assessed based on surgical characteristics and patient individualization. More multicenter studies are needed to clarify the dose-effect relationship and long-term safety.
期刊介绍：
Frontiers in Pharmacology is a leading journal in its field, publishing rigorously peer-reviewed research across disciplines, including basic and clinical pharmacology, medicinal chemistry, pharmacy and toxicology. Field Chief Editor Heike Wulff at UC Davis is supported by an outstanding Editorial Board of international researchers. This multidisciplinary open-access journal is at the forefront of disseminating and communicating scientific knowledge and impactful discoveries to researchers, academics, clinicians and the public worldwide.
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