No increase in complications seen with perioperative administration of tranexamic acid (Blood clotting agent given before and after surgery reduced life-threatening, major or critical organ bleeding by 28.6%, & little difference on cardio issues)

Medical Xpress / American College of Cardiology's 71st Annual Scientific Session ^ | Apr. 4, 2022 | P.J. Devereaux, MD, Ph.D. et al

[ConservativeMind]

Patients undergoing noncardiac surgery who received a single dose of tranexamic acid (TXA), which promotes blood clotting, at the beginning and end of their surgery had significantly less serious bleeding and needed fewer blood transfusions compared with patients treated with a placebo, based on findings. Researchers also observed no significant difference in the number of patients experiencing adverse events such as heart attacks, strokes or blood clots between the two patient groups.

"We saw an unequivocal benefit of treatment [with TXA] on preventing bleeding and blood transfusions, with no increased risk of complications," said P.J. Devereaux, MD, Ph.D.

In an international observational study of 40,000 adults who underwent noncardiac surgery, major bleeding was the most common life-threatening post-surgical complication, accounting for 17% of deaths within 30 days after surgery. Post-surgical bleeding can also result in serious complications, such as heart attack, stroke or kidney damage.

Surgery accounts for at least 40% of all blood transfusions, at a time when the global demand for blood for transfusions outpaces the supply.

After 30 days, 11.7% of patients in the placebo group had experienced life-threatening, major or critical organ bleeding compared with 9.1% of those in the TXA group, a highly statistically significant difference, Devereaux said. Rates of adverse cardiovascular events, however, were similar in both groups (14.2% for patients who received TXA, 13.9% for those who received a placebo). The benefit of TXA treatment was consistent, regardless of the type of noncardiac surgery patients received and whether patients' hemoglobin was normal or low before surgery.

"We have a clear, robust result showing that we can safely reduce postsurgical bleeding by giving a readily available drug immediately before and after noncardiac surgery," Devereaux said. "Moreover, it's a drug that we have a lot of experience with and in different settings, and it's inexpensive."

[ConservativeMind]

This could reduce our need for blood transfusions while minimizing subsequent organ bleeding.

[ConservativeMind]

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[sauropod]

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[Scarlett156]

This is a routine part of chest surgery.

[gas_dr]

We have been using this for years in cardiac, chest, ortho and ENT surgery. Any surgery where there is a risk for bleeding or observed bleeding. TXA is an antifibrinolytic for what its worth. It works on the back end of the clotting cascade where fibrin is broken down and stabilizes the blood clot to prevent further bleeding.

[ConservativeMind]

Thank you for that.

I guess the medical value of this study was simply to give a final “thumbs-up” for its continued use with non-cardiac surgery, if it was a common practice, already.

[cpdiii]

We have used it for many years. It works.
cpdiii pharmacist