Efficacy of aminocaproic, tranexamic acids in the control of bleeding during total knee replacement: a randomized clinical trial
Risks and costs of allogeneic blood transfusions mandate strategies to reduce blood loss in surgery. The objective of this study was to assess the efficacy of antifibrinolytic treatment in reducing perioperative blood loss during total knee replacement. A double-blind, randomized and placebo-control...
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| Veröffentlicht in: | British journal of anaesthesia : BJA 2006-05, Vol.96 (5), p.576-582 |
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| container_title | British journal of anaesthesia : BJA |
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| creator | Camarasa, M.A. Ollé, G. Serra-Prat, M. Martín, A. Sánchez, M. Ricós, P. Pérez, A. Opisso, L. |
| description | Risks and costs of allogeneic blood transfusions mandate strategies to reduce blood loss in surgery. The objective of this study was to assess the efficacy of antifibrinolytic treatment in reducing perioperative blood loss during total knee replacement.
A double-blind, randomized and placebo-controlled clinical trial was carried out on 127 patients undergoing total knee replacement. Patients in the study group received tranexamic acid 10 mg kg−1 i.v. just before the tourniquet was deflated and 3 h later, or epsilon-aminocaproic acid 100 mg kg−1 before tourniquet deflation followed by continuous perfusion (1 g h−1) during 3 h. External perioperative blood loss was measured and total blood loss was calculated. The number of patients transfused and number of packed red cell (PRC) units transfused was recorded and possible postoperative thromboembolic complications were investigated.
Total blood loss [mean (sd)] was 1099 ml (535) in the group that received antifibrinolytic agents and 1784 ml (660) in the control group (P |
| doi_str_mv | 10.1093/bja/ael057 |
| format | Article |
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A double-blind, randomized and placebo-controlled clinical trial was carried out on 127 patients undergoing total knee replacement. Patients in the study group received tranexamic acid 10 mg kg−1 i.v. just before the tourniquet was deflated and 3 h later, or epsilon-aminocaproic acid 100 mg kg−1 before tourniquet deflation followed by continuous perfusion (1 g h−1) during 3 h. External perioperative blood loss was measured and total blood loss was calculated. The number of patients transfused and number of packed red cell (PRC) units transfused was recorded and possible postoperative thromboembolic complications were investigated.
Total blood loss [mean (sd)] was 1099 ml (535) in the group that received antifibrinolytic agents and 1784 ml (660) in the control group (P<0.001). Five patients (7.5%) in the study group and 23 (38.3%) in the control group (P<0.001) received blood transfusions; the first group received a mean of 0.10 PRC unit per patient and the second, 0.58 (P<0.001). Mean reduction in haemoglobin levels (g dl−1) between preoperative and fifth day postoperative readings was 2.5 (0.9) in the study group and 3.4 (1.2) in the control group (P<0.001). Clinical assessment did not reveal any thromboembolic complications.
Antifibrinolytic agents produce a significant decrease in blood loss in patients undergoing total knee replacement, reflected in a reduction in the number of blood transfusions required.</description><identifier>ISSN: 0007-0912</identifier><identifier>EISSN: 1471-6771</identifier><identifier>DOI: 10.1093/bja/ael057</identifier><identifier>PMID: 16531440</identifier><identifier>CODEN: BJANAD</identifier><language>eng</language><publisher>Oxford: Elsevier Ltd</publisher><subject>6-aminocaproic acid ; Aged ; Aged, 80 and over ; agents ; agents, antifibrinolytic, 6-aminocaproic acid ; agents, antifibrinolytic, tranexamic acid ; Aminocaproic Acid - therapeutic use ; Anesthesia ; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy ; antifibrinolytic ; Antifibrinolytic Agents - therapeutic use ; arthroplasty ; Arthroplasty, Replacement, Knee ; Biological and medical sciences ; blood ; Blood Loss, Surgical - prevention & control ; Blood Transfusion ; blood, loss, surgical ; Double-Blind Method ; Female ; Hemoglobins - metabolism ; Hemostasis, Surgical - methods ; Humans ; knee replacement ; loss ; Male ; Medical sciences ; Middle Aged ; surgery ; surgery, arthroplasty, knee replacement ; surgical ; tranexamic acid ; Tranexamic Acid - therapeutic use ; Treatment Outcome</subject><ispartof>British journal of anaesthesia : BJA, 2006-05, Vol.96 (5), p.576-582</ispartof><rights>2006 British Journal of Anaesthesia</rights><rights>The Board of Management and Trustees of the British Journal of Anaesthesia 2006. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org 2006</rights><rights>2006 INIST-CNRS</rights><rights>Copyright British Medical Association May 2006</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c491t-3f3207b1a7cfb086174ce1248709f99c488f779e1fe20d5f7fe0b1da23393fc83</citedby><cites>FETCH-LOGICAL-c491t-3f3207b1a7cfb086174ce1248709f99c488f779e1fe20d5f7fe0b1da23393fc83</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=17772095$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/16531440$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Camarasa, M.A.</creatorcontrib><creatorcontrib>Ollé, G.</creatorcontrib><creatorcontrib>Serra-Prat, M.</creatorcontrib><creatorcontrib>Martín, A.</creatorcontrib><creatorcontrib>Sánchez, M.</creatorcontrib><creatorcontrib>Ricós, P.</creatorcontrib><creatorcontrib>Pérez, A.</creatorcontrib><creatorcontrib>Opisso, L.</creatorcontrib><title>Efficacy of aminocaproic, tranexamic acids in the control of bleeding during total knee replacement: a randomized clinical trial</title><title>British journal of anaesthesia : BJA</title><addtitle>Br J Anaesth</addtitle><description>Risks and costs of allogeneic blood transfusions mandate strategies to reduce blood loss in surgery. The objective of this study was to assess the efficacy of antifibrinolytic treatment in reducing perioperative blood loss during total knee replacement.
A double-blind, randomized and placebo-controlled clinical trial was carried out on 127 patients undergoing total knee replacement. Patients in the study group received tranexamic acid 10 mg kg−1 i.v. just before the tourniquet was deflated and 3 h later, or epsilon-aminocaproic acid 100 mg kg−1 before tourniquet deflation followed by continuous perfusion (1 g h−1) during 3 h. External perioperative blood loss was measured and total blood loss was calculated. The number of patients transfused and number of packed red cell (PRC) units transfused was recorded and possible postoperative thromboembolic complications were investigated.
Total blood loss [mean (sd)] was 1099 ml (535) in the group that received antifibrinolytic agents and 1784 ml (660) in the control group (P<0.001). Five patients (7.5%) in the study group and 23 (38.3%) in the control group (P<0.001) received blood transfusions; the first group received a mean of 0.10 PRC unit per patient and the second, 0.58 (P<0.001). Mean reduction in haemoglobin levels (g dl−1) between preoperative and fifth day postoperative readings was 2.5 (0.9) in the study group and 3.4 (1.2) in the control group (P<0.001). Clinical assessment did not reveal any thromboembolic complications.
Antifibrinolytic agents produce a significant decrease in blood loss in patients undergoing total knee replacement, reflected in a reduction in the number of blood transfusions required.</description><subject>6-aminocaproic acid</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>agents</subject><subject>agents, antifibrinolytic, 6-aminocaproic acid</subject><subject>agents, antifibrinolytic, tranexamic acid</subject><subject>Aminocaproic Acid - therapeutic use</subject><subject>Anesthesia</subject><subject>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</subject><subject>antifibrinolytic</subject><subject>Antifibrinolytic Agents - therapeutic use</subject><subject>arthroplasty</subject><subject>Arthroplasty, Replacement, Knee</subject><subject>Biological and medical sciences</subject><subject>blood</subject><subject>Blood Loss, Surgical - prevention & control</subject><subject>Blood Transfusion</subject><subject>blood, loss, surgical</subject><subject>Double-Blind Method</subject><subject>Female</subject><subject>Hemoglobins - metabolism</subject><subject>Hemostasis, Surgical - methods</subject><subject>Humans</subject><subject>knee replacement</subject><subject>loss</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>surgery</subject><subject>surgery, arthroplasty, knee replacement</subject><subject>surgical</subject><subject>tranexamic acid</subject><subject>Tranexamic Acid - therapeutic use</subject><subject>Treatment Outcome</subject><issn>0007-0912</issn><issn>1471-6771</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2006</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kUFrFTEUhYMo9lnd-AMkCLoQxyYzmZeJOy3VKg9EqVC6CZnMjeY1kzyTjLSu_OnmOYMFEVcXwpdz7rkHoYeUvKBENEf9Vh0pcKTlt9CKMk6rNef0NloRQnhFBK0P0L2UtoRQXov2Ljqg67ahjJEV-nlijNVKX-NgsBqtD1rtYrD6Oc5RebgqbxorbYeErcf5K2AdfI7B7T_0DmCw_gseprgfOWTl8KUHwBF2TmkYweeXWOGiNYTR_oABa2d9sXTFwCp3H90xyiV4sMxD9PnNydnxabX58Pbd8atNpZmguWpMUxPeU8W16Um3ppxpoDXrOBFGCM26znAugBqoydAaboD0dFB104jG6K45RE9n3ZLu2wQpy9EmDc6VkGFKcs07RlvRFvDxX-A2TNGX3SQVXNCWNXWBns2QjiGlCEbuoh1VvJaUyH0pspQi51IK_GhRnPoRhht0aaEATxZApXIYU46lbbrhOOc1-b3awoVp93_DauZsynD1h1TxssRseCtPzy_kx_dnr_nm07m8KDybeSgFfLcQZdIWvC7dRtBZDsH-y-YXQ23EdQ</recordid><startdate>20060501</startdate><enddate>20060501</enddate><creator>Camarasa, M.A.</creator><creator>Ollé, G.</creator><creator>Serra-Prat, M.</creator><creator>Martín, A.</creator><creator>Sánchez, M.</creator><creator>Ricós, P.</creator><creator>Pérez, A.</creator><creator>Opisso, L.</creator><general>Elsevier Ltd</general><general>Oxford University Press</general><general>Oxford Publishing Limited (England)</general><scope>6I.</scope><scope>AAFTH</scope><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>7X8</scope></search><sort><creationdate>20060501</creationdate><title>Efficacy of aminocaproic, tranexamic acids in the control of bleeding during total knee replacement: a randomized clinical trial</title><author>Camarasa, M.A. ; Ollé, G. ; Serra-Prat, M. ; Martín, A. ; Sánchez, M. ; Ricós, P. ; Pérez, A. ; Opisso, L.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c491t-3f3207b1a7cfb086174ce1248709f99c488f779e1fe20d5f7fe0b1da23393fc83</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2006</creationdate><topic>6-aminocaproic acid</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>agents</topic><topic>agents, antifibrinolytic, 6-aminocaproic acid</topic><topic>agents, antifibrinolytic, tranexamic acid</topic><topic>Aminocaproic Acid - therapeutic use</topic><topic>Anesthesia</topic><topic>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</topic><topic>antifibrinolytic</topic><topic>Antifibrinolytic Agents - therapeutic use</topic><topic>arthroplasty</topic><topic>Arthroplasty, Replacement, Knee</topic><topic>Biological and medical sciences</topic><topic>blood</topic><topic>Blood Loss, Surgical - prevention & control</topic><topic>Blood Transfusion</topic><topic>blood, loss, surgical</topic><topic>Double-Blind Method</topic><topic>Female</topic><topic>Hemoglobins - metabolism</topic><topic>Hemostasis, Surgical - methods</topic><topic>Humans</topic><topic>knee replacement</topic><topic>loss</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>surgery</topic><topic>surgery, arthroplasty, knee replacement</topic><topic>surgical</topic><topic>tranexamic acid</topic><topic>Tranexamic Acid - therapeutic use</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Camarasa, M.A.</creatorcontrib><creatorcontrib>Ollé, G.</creatorcontrib><creatorcontrib>Serra-Prat, M.</creatorcontrib><creatorcontrib>Martín, A.</creatorcontrib><creatorcontrib>Sánchez, M.</creatorcontrib><creatorcontrib>Ricós, P.</creatorcontrib><creatorcontrib>Pérez, A.</creatorcontrib><creatorcontrib>Opisso, L.</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>British journal of anaesthesia : BJA</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Camarasa, M.A.</au><au>Ollé, G.</au><au>Serra-Prat, M.</au><au>Martín, A.</au><au>Sánchez, M.</au><au>Ricós, P.</au><au>Pérez, A.</au><au>Opisso, L.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Efficacy of aminocaproic, tranexamic acids in the control of bleeding during total knee replacement: a randomized clinical trial</atitle><jtitle>British journal of anaesthesia : BJA</jtitle><addtitle>Br J Anaesth</addtitle><date>2006-05-01</date><risdate>2006</risdate><volume>96</volume><issue>5</issue><spage>576</spage><epage>582</epage><pages>576-582</pages><issn>0007-0912</issn><eissn>1471-6771</eissn><coden>BJANAD</coden><abstract>Risks and costs of allogeneic blood transfusions mandate strategies to reduce blood loss in surgery. The objective of this study was to assess the efficacy of antifibrinolytic treatment in reducing perioperative blood loss during total knee replacement.
A double-blind, randomized and placebo-controlled clinical trial was carried out on 127 patients undergoing total knee replacement. Patients in the study group received tranexamic acid 10 mg kg−1 i.v. just before the tourniquet was deflated and 3 h later, or epsilon-aminocaproic acid 100 mg kg−1 before tourniquet deflation followed by continuous perfusion (1 g h−1) during 3 h. External perioperative blood loss was measured and total blood loss was calculated. The number of patients transfused and number of packed red cell (PRC) units transfused was recorded and possible postoperative thromboembolic complications were investigated.
Total blood loss [mean (sd)] was 1099 ml (535) in the group that received antifibrinolytic agents and 1784 ml (660) in the control group (P<0.001). Five patients (7.5%) in the study group and 23 (38.3%) in the control group (P<0.001) received blood transfusions; the first group received a mean of 0.10 PRC unit per patient and the second, 0.58 (P<0.001). Mean reduction in haemoglobin levels (g dl−1) between preoperative and fifth day postoperative readings was 2.5 (0.9) in the study group and 3.4 (1.2) in the control group (P<0.001). Clinical assessment did not reveal any thromboembolic complications.
Antifibrinolytic agents produce a significant decrease in blood loss in patients undergoing total knee replacement, reflected in a reduction in the number of blood transfusions required.</abstract><cop>Oxford</cop><pub>Elsevier Ltd</pub><pmid>16531440</pmid><doi>10.1093/bja/ael057</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | 6-aminocaproic acid Aged Aged, 80 and over agents agents, antifibrinolytic, 6-aminocaproic acid agents, antifibrinolytic, tranexamic acid Aminocaproic Acid - therapeutic use Anesthesia Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy antifibrinolytic Antifibrinolytic Agents - therapeutic use arthroplasty Arthroplasty, Replacement, Knee Biological and medical sciences blood Blood Loss, Surgical - prevention & control Blood Transfusion blood, loss, surgical Double-Blind Method Female Hemoglobins - metabolism Hemostasis, Surgical - methods Humans knee replacement loss Male Medical sciences Middle Aged surgery surgery, arthroplasty, knee replacement surgical tranexamic acid Tranexamic Acid - therapeutic use Treatment Outcome |
| title | Efficacy of aminocaproic, tranexamic acids in the control of bleeding during total knee replacement: a randomized clinical trial |
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