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Arch Orthop Trauma Surg. 2015 Apr;135(4):465-71. doi: 10.1007/s00402-015-2168-z. Epub 2015 Feb 10.

Single dose intravenous tranexamic acid as effective as continuous infusion in primary total knee arthroplasty: a randomised clinical trial.

Author information

1
Department of Orthopedic Surgery, Polyclinique de la Thiérache, Rue du Dr Koral, 59212, Wignehies, France, hervehourlier@hotmail.fr.

Abstract

INTRODUCTION:

A randomised, double-blind clinical trial was conducted comparing the efficacy of tranexamic acid (TXA) as a single intravenous bolus or a continuous infusion to patients undergoing total knee arthroplasty (TKA). Study hypothesis was that a second dose of TXA would not offer any clinical benefits over the single infusion.

MATERIALS AND METHODS:

One hundred and six patients were randomised to a single intraoperative dose of 30 mg/kg tranexamic acid (OS group, n = 54), or to a loading dose of 10 mg/kg tranexamic acid followed 2 h later by a continuous 2 mg/kg/h infusion for 20 h (OD group, n = 52). The primary outcome was blood loss calculated from haematological values and perioperative transfusions. Secondary outcomes included the occurrence of major complications within the first postoperative year.

RESULTS:

All patients completed tranexamic acid therapy without adverse events. The mean blood loss was 1,148 ± 585 ml in group OS and 1,196 ± 614 ml in group OD (p = 0.68). No patients received a transfusion. There were no occurrences of major complications up to 6-weeks follow-up.

CONCLUSIONS:

The study demonstrated that a single bolus of tranexamic acid 30 mg/kg is as effective as a continuous infusion in patients undergoing tranexamic acid. The single application of tranexamic acid as part of routine care is recommended.

PMID:
25666288
DOI:
10.1007/s00402-015-2168-z
[Indexed for MEDLINE]

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