Intravenous Tranexamic Acid Reduces Blood Loss and Transfusion Volume in Scoliosis Surgery for Spinal Muscular Atrophy: Results of a 20-Year Retrospective Analysis
Intravenous tranexamic acid (TXA) has been administered to reduce intraoperative blood loss in scoliosis surgery. However, the therapeutic effect of TXA on spinal muscular atrophy (SMA) scoliosis surgery is not well demonstrated. Therefore, this study aimed to assess the efficacy of intravenous TXA...
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| Veröffentlicht in: | International journal of environmental research and public health 2021-09, Vol.18 (19), p.9959 |
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| creator | Chou, Shih-Hsiang Lin, Sung-Yen Wu, Meng-Huang Tien, Yin-Chun Jong, Yuh-Jyh Liang, Wen-Chen Lu, Yen-Mou Shih, Chia-Lung Lu, Cheng-Chang |
| description | Intravenous tranexamic acid (TXA) has been administered to reduce intraoperative blood loss in scoliosis surgery. However, the therapeutic effect of TXA on spinal muscular atrophy (SMA) scoliosis surgery is not well demonstrated. Therefore, this study aimed to assess the efficacy of intravenous TXA in SMA scoliosis surgery. From December 1993 to August 2020, 30 SMA patients who underwent scoliosis surgery (posterior fusion with fusion level of thoracic second or third to pelvis) were retrospectively enrolled and divided into the TXA group and non-TXA (control) group, with 15 patients in each group. Survey parameters were the amount of blood loss, blood transfusion, crystalloid transfusion volume, intubation time, and associated pulmonary complications (including pneumonia, pulmonary edema, and pulmonary atelectasis). The TXA group had significantly lesser blood loss than the control group (p = 0.011). Compared with the control group, the TXA group had significantly lower blood transfusion (p < 0.001), crystalloid volume (p = 0.041), and total transfusion volume (p = 0.005). In addition, the TXA group had fewer postoperative pulmonary complications, and patients with pulmonary complications were associated with a higher relative crystalloid volume and relative total transfusion volume (p = 0.003 and 0.022, respectively). In conclusion, TXA can be effective in reducing intraoperative blood loss and crystalloid fluid transfusions during scoliosis surgery in SMA patients, which may aid in reducing postoperative pulmonary complications. |
| doi_str_mv | 10.3390/ijerph18199959 |
| format | Article |
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However, the therapeutic effect of TXA on spinal muscular atrophy (SMA) scoliosis surgery is not well demonstrated. Therefore, this study aimed to assess the efficacy of intravenous TXA in SMA scoliosis surgery. From December 1993 to August 2020, 30 SMA patients who underwent scoliosis surgery (posterior fusion with fusion level of thoracic second or third to pelvis) were retrospectively enrolled and divided into the TXA group and non-TXA (control) group, with 15 patients in each group. Survey parameters were the amount of blood loss, blood transfusion, crystalloid transfusion volume, intubation time, and associated pulmonary complications (including pneumonia, pulmonary edema, and pulmonary atelectasis). The TXA group had significantly lesser blood loss than the control group (p = 0.011). Compared with the control group, the TXA group had significantly lower blood transfusion (p < 0.001), crystalloid volume (p = 0.041), and total transfusion volume (p = 0.005). In addition, the TXA group had fewer postoperative pulmonary complications, and patients with pulmonary complications were associated with a higher relative crystalloid volume and relative total transfusion volume (p = 0.003 and 0.022, respectively). In conclusion, TXA can be effective in reducing intraoperative blood loss and crystalloid fluid transfusions during scoliosis surgery in SMA patients, which may aid in reducing postoperative pulmonary complications.</description><identifier>ISSN: 1660-4601</identifier><identifier>ISSN: 1661-7827</identifier><identifier>EISSN: 1660-4601</identifier><identifier>DOI: 10.3390/ijerph18199959</identifier><identifier>PMID: 34639259</identifier><language>eng</language><publisher>Basel: MDPI AG</publisher><subject>Antifibrinolytic agents ; Atelectasis ; Atrophy ; Blood ; Blood transfusion ; Blood transfusions ; Bone surgery ; CAS ; Complications ; Computer assisted surgery ; Edema ; Intravenous administration ; Intubation ; Neuromuscular diseases ; Orthopedics ; Patients ; Pediatrics ; Pelvis ; Scoliosis ; Skin ; Spinal muscular atrophy ; Statistical analysis ; Surgery ; Thorax ; Transfusion ; Vertebrae</subject><ispartof>International journal of environmental research and public health, 2021-09, Vol.18 (19), p.9959</ispartof><rights>2021 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). 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However, the therapeutic effect of TXA on spinal muscular atrophy (SMA) scoliosis surgery is not well demonstrated. Therefore, this study aimed to assess the efficacy of intravenous TXA in SMA scoliosis surgery. From December 1993 to August 2020, 30 SMA patients who underwent scoliosis surgery (posterior fusion with fusion level of thoracic second or third to pelvis) were retrospectively enrolled and divided into the TXA group and non-TXA (control) group, with 15 patients in each group. Survey parameters were the amount of blood loss, blood transfusion, crystalloid transfusion volume, intubation time, and associated pulmonary complications (including pneumonia, pulmonary edema, and pulmonary atelectasis). The TXA group had significantly lesser blood loss than the control group (p = 0.011). Compared with the control group, the TXA group had significantly lower blood transfusion (p < 0.001), crystalloid volume (p = 0.041), and total transfusion volume (p = 0.005). In addition, the TXA group had fewer postoperative pulmonary complications, and patients with pulmonary complications were associated with a higher relative crystalloid volume and relative total transfusion volume (p = 0.003 and 0.022, respectively). In conclusion, TXA can be effective in reducing intraoperative blood loss and crystalloid fluid transfusions during scoliosis surgery in SMA patients, which may aid in reducing postoperative pulmonary complications.</description><subject>Antifibrinolytic agents</subject><subject>Atelectasis</subject><subject>Atrophy</subject><subject>Blood</subject><subject>Blood transfusion</subject><subject>Blood transfusions</subject><subject>Bone surgery</subject><subject>CAS</subject><subject>Complications</subject><subject>Computer assisted surgery</subject><subject>Edema</subject><subject>Intravenous administration</subject><subject>Intubation</subject><subject>Neuromuscular diseases</subject><subject>Orthopedics</subject><subject>Patients</subject><subject>Pediatrics</subject><subject>Pelvis</subject><subject>Scoliosis</subject><subject>Skin</subject><subject>Spinal muscular atrophy</subject><subject>Statistical analysis</subject><subject>Surgery</subject><subject>Thorax</subject><subject>Transfusion</subject><subject>Vertebrae</subject><issn>1660-4601</issn><issn>1661-7827</issn><issn>1660-4601</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><recordid>eNpdkV9rFDEUxYMotq6--hzwxZdpk8lMMvFBWIt_CiuFbhV8Cmlyp5slMxmTyeJ-Hr-o2bYU26cbOCeHe38HobeUnDAmyanbQpw2tKNSylY-Q8eUc1I1nNDn_72P0KuUtoSwruHyJTpiDWeybuUx-ns-zlHvYAw54auoR_ijB2fw0jiLL8FmAwl_8iFYvAopYT3aW1vqc3JhxD-DzwNgN-K1Cd6F5BJe53gDcY_7EPF6cqP2-HtOJnsd8XKOYdrsP5TslP2ccOixxjWpfkFRL6HIaQIzux3gZfm5L4Gv0Yte-wRv7ucC_fjy-ersW7W6-Hp-tlxVhsl2rnhrKGjSEKmZ7bu-7a4bwajoa2j7Bixo0WguDVDCqKUgJABlgmujLdNQswX6eJc75esBrIEDGq-m6AYd9ypopx4ro9uom7BTXUsE54eA9_cBMfzOkGY1uGTA-4K18FV125WmBC_0F-jdE-s25FgOvnURKUTHDq6TO5cpWFKE_mEZStShf_W4f_YPwKOnNA</recordid><startdate>20210922</startdate><enddate>20210922</enddate><creator>Chou, Shih-Hsiang</creator><creator>Lin, Sung-Yen</creator><creator>Wu, Meng-Huang</creator><creator>Tien, Yin-Chun</creator><creator>Jong, Yuh-Jyh</creator><creator>Liang, Wen-Chen</creator><creator>Lu, Yen-Mou</creator><creator>Shih, Chia-Lung</creator><creator>Lu, Cheng-Chang</creator><general>MDPI AG</general><general>MDPI</general><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8C1</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0003-1606-2444</orcidid><orcidid>https://orcid.org/0000-0002-7194-9147</orcidid><orcidid>https://orcid.org/0000-0002-3458-9939</orcidid></search><sort><creationdate>20210922</creationdate><title>Intravenous Tranexamic Acid Reduces Blood Loss and Transfusion Volume in Scoliosis Surgery for Spinal Muscular Atrophy: Results of a 20-Year Retrospective Analysis</title><author>Chou, Shih-Hsiang ; 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However, the therapeutic effect of TXA on spinal muscular atrophy (SMA) scoliosis surgery is not well demonstrated. Therefore, this study aimed to assess the efficacy of intravenous TXA in SMA scoliosis surgery. From December 1993 to August 2020, 30 SMA patients who underwent scoliosis surgery (posterior fusion with fusion level of thoracic second or third to pelvis) were retrospectively enrolled and divided into the TXA group and non-TXA (control) group, with 15 patients in each group. Survey parameters were the amount of blood loss, blood transfusion, crystalloid transfusion volume, intubation time, and associated pulmonary complications (including pneumonia, pulmonary edema, and pulmonary atelectasis). The TXA group had significantly lesser blood loss than the control group (p = 0.011). Compared with the control group, the TXA group had significantly lower blood transfusion (p < 0.001), crystalloid volume (p = 0.041), and total transfusion volume (p = 0.005). In addition, the TXA group had fewer postoperative pulmonary complications, and patients with pulmonary complications were associated with a higher relative crystalloid volume and relative total transfusion volume (p = 0.003 and 0.022, respectively). In conclusion, TXA can be effective in reducing intraoperative blood loss and crystalloid fluid transfusions during scoliosis surgery in SMA patients, which may aid in reducing postoperative pulmonary complications.</abstract><cop>Basel</cop><pub>MDPI AG</pub><pmid>34639259</pmid><doi>10.3390/ijerph18199959</doi><orcidid>https://orcid.org/0000-0003-1606-2444</orcidid><orcidid>https://orcid.org/0000-0002-7194-9147</orcidid><orcidid>https://orcid.org/0000-0002-3458-9939</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Antifibrinolytic agents Atelectasis Atrophy Blood Blood transfusion Blood transfusions Bone surgery CAS Complications Computer assisted surgery Edema Intravenous administration Intubation Neuromuscular diseases Orthopedics Patients Pediatrics Pelvis Scoliosis Skin Spinal muscular atrophy Statistical analysis Surgery Thorax Transfusion Vertebrae |
| title | Intravenous Tranexamic Acid Reduces Blood Loss and Transfusion Volume in Scoliosis Surgery for Spinal Muscular Atrophy: Results of a 20-Year Retrospective Analysis |
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