Covid
Ramesh Baradaran Bagheri
Abstract
Introduction: TXA may lessen the need for hysterectomy, lessen the risk of developing severe anemia, and prevent the need for blood transfusions, all of which could significantly advance the objective of lowering maternal mortality, according to several RCTs that have examined the prophylactic role of ...
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Introduction: TXA may lessen the need for hysterectomy, lessen the risk of developing severe anemia, and prevent the need for blood transfusions, all of which could significantly advance the objective of lowering maternal mortality, according to several RCTs that have examined the prophylactic role of the drug (described in the discussion). Material and Methods: To make TXA injection, 1 gram (10ml) of TXA was diluted in 100ml of sterile saline. To those in the study group, TXA was infused intravenously for more than 15 minutes, at least 20 minutes before making a skin incision. The control group received no medication at all. All of the participants received spinal anesthesia. Surgery was performed by assistant professors with an MD degree and at least three years of experience. Results: Primary outcomes included blood loss from placental delivery to the conclusion of surgery and the percentage of hemoglobin difference, while secondary outcomes included the length of surgery and the percentage of patients who lost more than 500 ml of blood. There was a significant difference between the two groups in these primary and secondary outcomes. Conclusion: TXA significantly decreased the amount of blood lost during LSCS. Being in a hypercoagulable state during pregnancy increases the risk of thrombotic events. However, there were no negative side effects or complications in the first few weeks after delivery when this antifibrinolytic was used. So, when subjects are undergoing LSCS, TXA can be applied effectively and safely.
Medicine
Amin Moradi; Naghi Abedini
Abstract
Introduction: Our study compared the effectiveness of tranexamic acid in patients undergoing TKA using the three different administration methods—IV, IA, and combined IV and IA—in terms of total blood loss and the rate of allogeneic transfusion. We also wanted to compare the frequency of ...
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Introduction: Our study compared the effectiveness of tranexamic acid in patients undergoing TKA using the three different administration methods—IV, IA, and combined IV and IA—in terms of total blood loss and the rate of allogeneic transfusion. We also wanted to compare the frequency of wound complications and venous thromboembolism (VTE) among these regimens.Material and Methods: 66 TKA patients were divided into four groups based on the route of tranexamic acid administration: IV only, IA only, low-dose combined (IV + IA injection of 1 g), and high-dose combined (IV + IA injection of 2 g). This research involved 66 patients who underwent TKA between March 2019 and March 2020. Comparing the groups revealed differences in the estimated total blood loss, allogeneic transfusion rate, hemoglobin loss, frequency of symptomatic deep vein thrombosis and pulmonary embolism, wound complications, and periprosthetic joint infection.Results: There were no differences between the other three groups, but the combined high and low dose group and the IA only group lost less blood overall than the IV only group did. None of the study groups' patients received an allogeneic transfusion. There were no other symptomatic VTE events in any group, with the exception of one patient in the IV-only group who developed a symptomatic pulmonary embolism.Conclusion: Regardless of whether it is combined with IV administration, IA tranexamic acid administration further reduces blood loss after unilateral TKA compared to IV use alone. With respect to further reducing blood loss in comparison to IA alone, this study did not find any additional effects of IV combination.
Medicine
Mohammad Irajian; Vahid Fattahi
Abstract
Knee arthroplasty is a type of surgery that replaces the joint surface of the femur and leg bones in the knee joint with an artificial surface. Tranexamic acid binds to the binding sites of lysine in plasmin and plasminogen and thereby displaces plasminogen from the surface of fibrin and thus inhibits ...
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Knee arthroplasty is a type of surgery that replaces the joint surface of the femur and leg bones in the knee joint with an artificial surface. Tranexamic acid binds to the binding sites of lysine in plasmin and plasminogen and thereby displaces plasminogen from the surface of fibrin and thus inhibits fibrinolysis. Local use of tranexamic acid can reduce bleeding in gynecological and obstetric surgeries, especially after delivery, urological surgery, oral surgery in hemophilia patients, and brain and spinal cord surgeries. Tranexamic acid is a plasminogen inhibitor and also inhibits urokinase activators. Tranexamic acid can be used orally and intravenously. Urokinase is a physiological thrombolytic agent that is produced in the kidney parenchymal cells and found in the urine. Urokinase binds directly to plasminogen and produces plasmin. Tranexamic acid is a synthetic derivative of the amino acid lysine and an antifibrinolytic agent that binds to plasminogen and prevents the interaction of plasminogen with fibrin and prevents fibrin clot dissolution. Urine and urothelium contain high concentrations of plasminogen activators. Tranexamic acid is used to reduce bleeding in heart surgeries, liver transplants, orthopedic surgeries, as well as in cases of arthroplasty and knee joint replacement, and to reduce bleeding after prostatectomy or tooth extraction. Also, this drug is used to treat idiopathic menorrhagia (20-23). Although prostate surgery is a very common surgery, little study was done on strategies to reduce the amount of transfusion, and there is still no universally accepted method.
