TY - JOUR
T1 - The use of tranexamic acid to reduce surgical blood loss
T2 - A review basic science, subspecialty studies, and the evolution of use in spine deformity surgery
AU - Slattery, Casey
AU - Kark, Jonathan
AU - Wagner, Theodore
AU - Verma, Kushagra
N1 - Publisher Copyright:
© 2019 Wolters Kluwer Health, Inc.
PY - 2019
Y1 - 2019
N2 - Significant blood loss is often seen in orthopedic surgeries, especially complex spinal procedures that constitute long surgical times, large incisions, and rich blood supplies. Tranexamic acid (TXA), a synthetic analog of the amino acid lysine, has proven to be a cost-effective method in decreasing transfusion rates and avoiding complications associated with low blood volume. Recent data on TXA's use in spine surgery suggest that TXA remains both efficacious and safe, although the ideal dosing and timing of administration is still a point of disagreement. The purpose of this study is to review the literature for the use of TXA in spine surgery to better understand its safety profile and ideal dosage. This narrative review on TXA was conducted on prospective orthopedic studies that used TXA in spine deformity surgery. TXA in adult and pediatric spine surgery has decreased intraoperative and postoperative blood loss, decreasing the need for blood transfusions. The most common dose in the literature is a 10 mg/kg loading dose, followed by 1 mg/kg per hour. Although the proper dosing of TXA for spine surgery remains debatable, studies have proven that TXA is effective at reducing blood loss without increasing the risk of thrombotic events.
AB - Significant blood loss is often seen in orthopedic surgeries, especially complex spinal procedures that constitute long surgical times, large incisions, and rich blood supplies. Tranexamic acid (TXA), a synthetic analog of the amino acid lysine, has proven to be a cost-effective method in decreasing transfusion rates and avoiding complications associated with low blood volume. Recent data on TXA's use in spine surgery suggest that TXA remains both efficacious and safe, although the ideal dosing and timing of administration is still a point of disagreement. The purpose of this study is to review the literature for the use of TXA in spine surgery to better understand its safety profile and ideal dosage. This narrative review on TXA was conducted on prospective orthopedic studies that used TXA in spine deformity surgery. TXA in adult and pediatric spine surgery has decreased intraoperative and postoperative blood loss, decreasing the need for blood transfusions. The most common dose in the literature is a 10 mg/kg loading dose, followed by 1 mg/kg per hour. Although the proper dosing of TXA for spine surgery remains debatable, studies have proven that TXA is effective at reducing blood loss without increasing the risk of thrombotic events.
KW - TXA
KW - antifibrinolytic
KW - blood loss
KW - spine deformity surgery
KW - tranexamic acid
UR - http://www.scopus.com/inward/record.url?scp=85061896872&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85061896872&partnerID=8YFLogxK
U2 - 10.1097/BSD.0000000000000808
DO - 10.1097/BSD.0000000000000808
M3 - Review article
C2 - 30789494
AN - SCOPUS:85061896872
SN - 2380-0186
SP - 46
EP - 50
JO - Clinical Spine Surgery
JF - Clinical Spine Surgery
ER -