The Role of Tranexamic Acid in the Prevention of Perioperative Hemorrhage
DOI:
https://doi.org/10.48111/2022.02.04Keywords:
tranexamic acid, prevention of hemorrhage, intraoperative, general surgery, perioperative, antifibrinolyticAbstract
IMPORTANCE Significant blood loss can occur as a result of trauma, surgery, anticoagulation, obstetric complications, and hemostatic disorders. As there are many diverse causes of hemorrhage, the availability of a clinically safe and effective hemostatic agent is the need of the hour. Tranexamic acid is one of the most commonly used and widely researched anti-fibrinolytic agents. Its role in trauma-associated, postoperative, and postpartum hemorrhage has been well recognized. However, the utility of tranexamic acid goes farther than these common indications, supported by accruing data suggesting its ability to reduce blood loss along with improvement in clinical outcomes in many hemostatic challenges without increasing thromboembolic risk.
OBJECTIVE To review the clinical application and effectiveness of tranexamic acid in the prevention of intraoperative hemorrhage.
METHODS: Secondary data were selected by utilizing three steps; identification of 490 articles, recruitment of 116 articles, and selection of 61 articles for the systematic review. Inclusion and exclusion criteria were designed according to PRISMA protocol.
RESULTS Tranexamic acid has reduced perioperative hemorrhage and blood transfusion requirements in elective surgical procedures. Many studies established the efficacy of tranexamic acid and its safety without raising thromboembolic risk, precipitating kidney failure, or their complications.
CONCLUSION In multiple clinical scenarios, tranexamic acid has proven to prevent hemorrhage without increasing thromboembolic risk and has broad-spectrum clinical indications. However, more caution and regulatory guidelines need to be established to prevent the rare incidence of complications so as thromboembolism and seizures.
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