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Tranexamic acid reduces blood loss in paediatric proximal femoral and/or pelvic osteotomies

PURPOSE: Proximal femoral and/or pelvic osteotomies (PFPO) are associated with significant blood loss, which can be harmful, especially in paediatric patients. Therefore, considering methods to reduce blood loss is important. The purpose of this study was to examine the efficacy of tranexamic acid (...

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Autores principales: Brouwer, Anne J., Kempink, Dagmar R.J., de Witte, Pieter Bas
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The British Editorial Society of Bone & Joint Surgery 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8223094/
https://www.ncbi.nlm.nih.gov/pubmed/34211600
http://dx.doi.org/10.1302/1863-2548.15.200249
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author Brouwer, Anne J.
Kempink, Dagmar R.J.
de Witte, Pieter Bas
author_facet Brouwer, Anne J.
Kempink, Dagmar R.J.
de Witte, Pieter Bas
author_sort Brouwer, Anne J.
collection PubMed
description PURPOSE: Proximal femoral and/or pelvic osteotomies (PFPO) are associated with significant blood loss, which can be harmful, especially in paediatric patients. Therefore, considering methods to reduce blood loss is important. The purpose of this study was to examine the efficacy of tranexamic acid (TXA) in reducing intraoperative estimated blood loss (EBL) in paediatric patients undergoing a PFPO. METHODS: Paediatric patients who had a PFPO between 2014 and 2019 were retrospectively reviewed. Outcome measures included patient demographics, TXA use (none, preoperative and/or intraoperative bolus, pump), EBL, transfusion rate and thromboembolic complications. Univariate and multivariate analyses were performed to assess associations between investigated outcome measures and EBL. RESULTS: A total of 340 PFPO (263 patients) were included. Mean age at surgery was 8.0 years (sd 4.3). In all, 269 patients received no TXA, 20 had a preoperative bolus, 43 had an intraoperative bolus and eight patients had other TXA regimes (preoperative and intraoperative bolus or pump). Overall, mean blood loss was 211 ml (sd 163). Multivariate analysis showed significant associations between higher EBL and higher age at surgery, male sex, higher body mass index and longer procedure time. There was a significant association between lower EBL and a preoperative TXA bolus: 66 ml (33%) less EBL compared with patients without TXA (95% confidence interval -129 to -4; p = 0.04). No thromboembolic complications were reported in any of the studied patients. CONCLUSION: Preoperative TXA administration is associated with a decreased EBL in PFPO. No thromboembolic events were reported. Administering TXA preoperatively appears to be effective in paediatric patients undergoing a PFPO. LEVEL OF EVIDENCE: Level III – retrospective comparative study.
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spelling pubmed-82230942021-06-30 Tranexamic acid reduces blood loss in paediatric proximal femoral and/or pelvic osteotomies Brouwer, Anne J. Kempink, Dagmar R.J. de Witte, Pieter Bas J Child Orthop Original Clinical Article PURPOSE: Proximal femoral and/or pelvic osteotomies (PFPO) are associated with significant blood loss, which can be harmful, especially in paediatric patients. Therefore, considering methods to reduce blood loss is important. The purpose of this study was to examine the efficacy of tranexamic acid (TXA) in reducing intraoperative estimated blood loss (EBL) in paediatric patients undergoing a PFPO. METHODS: Paediatric patients who had a PFPO between 2014 and 2019 were retrospectively reviewed. Outcome measures included patient demographics, TXA use (none, preoperative and/or intraoperative bolus, pump), EBL, transfusion rate and thromboembolic complications. Univariate and multivariate analyses were performed to assess associations between investigated outcome measures and EBL. RESULTS: A total of 340 PFPO (263 patients) were included. Mean age at surgery was 8.0 years (sd 4.3). In all, 269 patients received no TXA, 20 had a preoperative bolus, 43 had an intraoperative bolus and eight patients had other TXA regimes (preoperative and intraoperative bolus or pump). Overall, mean blood loss was 211 ml (sd 163). Multivariate analysis showed significant associations between higher EBL and higher age at surgery, male sex, higher body mass index and longer procedure time. There was a significant association between lower EBL and a preoperative TXA bolus: 66 ml (33%) less EBL compared with patients without TXA (95% confidence interval -129 to -4; p = 0.04). No thromboembolic complications were reported in any of the studied patients. CONCLUSION: Preoperative TXA administration is associated with a decreased EBL in PFPO. No thromboembolic events were reported. Administering TXA preoperatively appears to be effective in paediatric patients undergoing a PFPO. LEVEL OF EVIDENCE: Level III – retrospective comparative study. The British Editorial Society of Bone & Joint Surgery 2021-06-01 /pmc/articles/PMC8223094/ /pubmed/34211600 http://dx.doi.org/10.1302/1863-2548.15.200249 Text en Copyright © 2021, The author(s) https://creativecommons.org/licenses/by-nc/4.0/Open Access This article is distributed under the terms of the Creative Commons Attribution-Non Commercial 4.0 International (CC BY-NC 4.0) licence (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed.
spellingShingle Original Clinical Article
Brouwer, Anne J.
Kempink, Dagmar R.J.
de Witte, Pieter Bas
Tranexamic acid reduces blood loss in paediatric proximal femoral and/or pelvic osteotomies
title Tranexamic acid reduces blood loss in paediatric proximal femoral and/or pelvic osteotomies
title_full Tranexamic acid reduces blood loss in paediatric proximal femoral and/or pelvic osteotomies
title_fullStr Tranexamic acid reduces blood loss in paediatric proximal femoral and/or pelvic osteotomies
title_full_unstemmed Tranexamic acid reduces blood loss in paediatric proximal femoral and/or pelvic osteotomies
title_short Tranexamic acid reduces blood loss in paediatric proximal femoral and/or pelvic osteotomies
title_sort tranexamic acid reduces blood loss in paediatric proximal femoral and/or pelvic osteotomies
topic Original Clinical Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8223094/
https://www.ncbi.nlm.nih.gov/pubmed/34211600
http://dx.doi.org/10.1302/1863-2548.15.200249
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