Use of topical tranexamic acid or aminocaproic acid to prevent bleeding after major surgical procedures;Uso Trópico de Ácido Tranexámico y Ácido Aminocaproico Para la Prevención del Sangrado Tras un Procedimiento Quirúrgico Mayor

Annals of Pharmacotherapy

Volumn 46, Issue 1, 2012, Pages 97-107

  Ipema, Heather J ^a   Tanzi, Maria G ^a  

^a UNIVERSITY OF ILLINOIS AT CHICAGO   (United States)

Author keywords

Aminocaproic acid; Antifibrinolytic; Surgical bleeding; Topical; Tranexamic acid

Indexed keywords

AMINOCAPROIC ACID; ANTIFIBRINOLYTIC AGENT; APROTININ; CARBAZOCHROME; CARBAZOCHROME SODIUM SULFATE; DESMOPRESSIN; HEMOSTATIC AGENT; PLACEBO; RECOMBINANT BLOOD CLOTTING FACTOR 7A; SODIUM CHLORIDE; TRANEXAMIC ACID; UNCLASSIFIED DRUG;

BLEEDING; BLOOD TRANSFUSION; HEART SURGERY; HUMAN; ORTHOPEDIC SURGERY; PRIORITY JOURNAL; REVIEW; STERNOTOMY;

ADMINISTRATION, TOPICAL; AMINOCAPROIC ACIDS; ANTIFIBRINOLYTIC AGENTS; CARDIAC SURGICAL PROCEDURES; CLINICAL TRIALS AS TOPIC; HUMANS; ORTHOPEDIC PROCEDURES; POSTOPERATIVE HEMORRHAGE; PRACTICE GUIDELINES AS TOPIC; TRANEXAMIC ACID;

EID: 84855679062     PISSN: 10600280     EISSN: None     Source Type: Journal    
DOI: 10.1345/aph.1Q383     Document Type: Review

References (77)

1. Society of Thoracic Surgeons Blood Conservation Guideline Task Force, Society of Cardiovascular Anesthesiologists Special Task Force on Blood Transfusion, and International Consortium for Evidence Based Perfusion. 2011 Update to the Society of Thoracic Surgeons and The Society of Cardiovascular Anesthesiologists blood conservation clinical practice guidelines. Ann Thorac Surg 2011;91:944-82. DOI 10.1016/j.athoracsur.2010.11.078
2. American Society of Anesthesiologists Task Force on Perioperative Blood Transfusion and Adjuvant Therapies. Practice guidelines for perioperative blood transfusion and adjuvant therapies: an updated report by the American Society of Anesthesiologists Task Force on Perioperative Blood Transfusion and Adjuvant Therapies. Anesthesiology 2006;105:198-208.
3. Engoren MC, Habib RH, Zacharias A, Schwann TA, Riordan CJ, Durham SJ. Effect of blood transfusion on long-term survival after cardiac operation. Ann Thorac Surg 2002;74:1180-6. DOI 10.1016/S0003-4975(02)03766-9
4. Porte RJ, Leebeek FW. Pharmacological strategies to decrease transfusion requirements in patients undergoing surgery. Drugs 2002;62:2193-211.
5. Eubanks JD. Antifibrinolytics in major orthopaedic surgery. J Am Acad Orthop Surg 2010;18:132-8.
6. Gabay M. Absorbable hemostatic agents. Am J Health Syst Pharm 2006;63:1244-53. DOI 10.2146/ajhp060003
7. Fergusson DA, Hébert PC, Mazer CD, et al. A comparison of aprotinin and lysine analogs in high-risk cardiac surgery. N Engl J Med 2008;358:2319-31. DOI 10.1056/NEJMoa0802395
8. Food and Drug Administration. Aprotinin injection (marketed as Trasylol) information. www.fda.gov/drugs/drugsafety/postmarketdrugsafetyinformationforpatientsandproviders/ucm142720.htm (accessed 2011 Jun 10).
9. US special access protocol for Trasylol. http://www.trasylol.com/Trasylol_10-22-09.pdf (accessed 2011 Jun 10).
10. Product information. Aminocaproic acid injection. Lake Forest, IL: Hospira, June 2007.
11. Product information. Cyklokapron (tranexamic acid). New York, NY: Pfizer Inc., January 2011.
12. Levy JH. Pharmacologic methods to reduce perioperative bleeding. Transfusion 2008;48(1 suppl):31S-38S. DOI 10.1111/j.1537-2995.2007.01574.x
13. Koster A, Schirmer U. Re-evaluation of the role of antifibrinolytic therapy with lysine analogs during cardiac surgery in the post aprotinin era. Curr Opin Anaesthesiol 2011;24:92-7. DOI 10.1097/ACO.0b013e32833ff3eb
14. Ngaage DL, Bland JM. Lessons from aprotinin: is the routine use and inconsistent dosing of tranexamic acid prudent? Meta-analysis of randomised and large matched observational studies. Eur J Cardiothorac Surg 2010;37:1375-83. DOI 10.1016/j.ejcts.2009.11.055
15. Henry DA, Carless PA, Moxey AJ, et al. Anti-fibrinolytic use for minimising perioperative allogeneic blood transfusion. Cochrane Database Syst Rev 2011;1:CD001886. DOI 10.1002/14651858.CD001886.pub4
16. Mannucci PM. Hemostatic drugs. N Engl J Med 1998;339:245-53. DOI 10.1056/NEJM199807233390407
17. Adler Ma SC, Brindle W, Burton G, et al. Tranexamic acid is associated with less blood transfusion in off-pump coronary artery bypass graft surgery: a systematic review and meta-analysis. J Cardiothorac Vasc Anesth 2011;25:26-35. DOI 10.1053/j.jvca.2010.08.012
18. Sukeik M, Alshryda S, Haddad FS, Mason JM. Systematic review and meta-analysis of the use of tranexamic acid in total hip replacement. J Bone Joint Surg Br 2011;93:39-46. DOI 10.1302/0301-620X.93B1.24984
19. Kagoma YK, Crowther MA, Douketis J, Bhandari M, Eikelboom J, Lim W. Use of antifibrinolytic therapy to reduce transfusion in patients undergoing orthopedic surgery: a systematic review of randomized trials. Thromb Res 2009;123:687-96. DOI 10.1016/j.thromres.2008.09.015
20. Molenaar IQ, Warnaar N, Groen H, Tenvergert EM, Slooff MJ, Porte RJ. Efficacy and safety of antifibrinolytic drugs in liver transplantation: a systematic review and meta-analysis. Am J Transplant 2007;7:185-94. DOI 10.1111/j.1600-6143.2006.01591.x
21. Gill JB, Rosenstein A. The use of antifibrinolytic agents in total hip arthroplasty: a meta-analysis. J Arthroplasty 2006;21:869-73. DOI 10.1016/j.arth.2005.09.009
22. Ho KM, Ismail H. Use of intravenous tranexamic acid to reduce allogeneic blood transfusion in total hip and knee arthroplasty: a meta-analysis. Anaesth Intensive Care 2003;31:529-37.
23. Levi M, Cromheecke ME, de Jonge E, et al. Pharmacological strategies to decrease excessive blood loss in cardiac surgery: a meta-analysis of clinically relevant endpoints. Lancet 1999;354:1940-7. DOI 10.1016/S0140-6736(99)01264-7
24. Munoz JJ, Birkmeyer NJ, Birkmeyer JD, O'Connor GT, Dacey LJ. Is epsilon-aminocaproic acid as effective as aprotinin in reducing bleeding with cardiac surgery? A meta-analysis. Circulation 1999;99:81-9.
25. Zufferey P, Merquiol F, Laporte S, et al. Do antifibrinolytics reduce allogeneic blood transfusion in orthopedic surgery? Anesthesiology 2006;105:1034-46.
26. Martin K, Wiesner G, Breuer T, Lange R, Tassani P. The risks of aprotinin and tranexamic acid in cardiac surgery: a one-year follow-up of 1188 consecutive patients. Anesth Analg 2008;107:1783-90. DOI 10.1213/ane.0b013e318184bc20
27. Murkin JM, Falter F, Granton J, Young B, Burt C, Chu M. High-dose tranexamic acid is associated with nonischemic clinical seizures in cardiac surgical patients. Anesth Analg 2010;110:350-3. DOI 10.1213/ANE.0b013e3181c92b23
28. Sander M, Spies CD, Martiny V, Rosenthal C, Wernecke KD, von Heymann C. Mortality associated with administration of high-dose tranexamic acid and aprotinin in primary open-heart procedures: a retrospective analysis. Crit Care 2010;14:R148. DOI 10.1186/cc9216
29. Keyl C, Uhl R, Beyersdorf F, et al. High-dose tranexamic acid is related to increased risk of generalized seizures after aortic valve replacement. Eur J Cardiothorac Surg 2011;39:e114-21. DOI 10.1016/j.ejcts.2010.12.030
30. Martin K, Knorr J, Breuer T, et al. Seizures after open heart surgery: comparison of c-aminocaproic acid and tranexamic acid. J Cardiothorac Vasc Anesth 2011;25:20-5. DOI 10.1053/j.jvca.2010.10.007
31. Berman M, Cardone D, Sharples L, et al. Safety and efficacy of aprotinin and tranexamic acid in pulmonary endarterectomy surgery with hypothermia: review of 200 patients. Ann Thorac Surg 2010;90:1432-6. DOI 10.1016/j.athoracsur.2010.06.083
32. Maslow AD, Chaudrey A, Bert A, Schwartz C, Singh A. Perioperative renal outcome in cardiac surgical patients with preoperative renal dysfunction: aprotinin versus epsilon aminocaproic acid. J Cardiothorac Vasc Anesth 2008;22:6-15. DOI 10.1053/j.jvca.2007.07.017
33. Karkouti K, Beattie WS, Dattilo KM, et al. A propensity score case-control comparison of aprotinin and tranexamic acid in high-transfusion-risk cardiac surgery. Transfusion 2006;46:327-38. DOI 10.1111/j.1537-2995.2006.00724.x
34. Stafford-Smith M, Phillips-Bute B, Reddan DN, Black J, Newman MF. The association of epsilon-aminocaproic acid with postoperative decrease in creatinine clearance in 1502 coronary bypass patients. Anesth Analg 2000;91:1085-90.
35. Carter G, Goss A, Lloyd J, Tocchetti R. Tranexamic acid mouthwash versus autologous fibrin glue in patients taking warfarin undergoing dental extractions: a randomized prospective clinical study. J Oral Maxillofac Surg 2003;61:1432-5.
36. Carter G, Goss A. Tranexamic acid mouthwash-a prospective randomized study of a 2-day regimen vs 5-day regimen to prevent postoperative bleeding in anticoagulated patients requiring dental extractions. Int J Oral Maxillofac Surg 2003;32:504-7.
37. Ramström G, Sindet-Pedersen S, Hall G, Blombäck M, Alander U. Prevention of postsurgical bleeding in oral surgery using tranexamic acid without dose modification of oral anticoagulants. J Oral Maxillofac Surg 1993;51:1211-6.
38. Sindet-Pedersen S, Ramström G, Bernvil S, Blombäck M. Hemostatic effect of tranexamic acid mouthwash in anticoagulant-treated patients undergoing oral surgery. N Engl J Med 1989;320:840-3. DOI 10.1056/NEJM198903303201305
39. Sindet-Pedersen S, Stenbjerg S. Effect of local antifibrinolytic treatment with tranexamic acid in hemophiliacs undergoing oral surgery. J Oral Maxillofac Surg 1986;44:703-7.
40. Waly NG. Local antifibrinolytic treatment with tranexamic acid in hemophilic children undergoing dental extractions. Egypt Dent J 1995;41:961-8.
41. Lee APH, Boyle CA, Savidge GF, Fiske J. Effectiveness in controlling haemorrhage after dental scaling in people with haemophilia by using tranexamic acid mouthwash. Br Dent J 2005;198:33-8. DOI 10.1038/sj.bdj.4811955
42. Stajcíc Z, Baklaja R, Elezovíc I, Rolovíc Z. Primary wound closure in haemophiliacs undergoing dental extractions. Int J Oral Maxillofac Surg 1989;18:14-6.
43. Karkhaneh R, Naeeni M, Chams H, Adbollahi M, Mansouri MR. Topical aminocaproic acid to prevent rebleeding in cases of traumatic hyphema. Eur J Ophthalmol 2003;13:57-61.
44. Pieramici DJ, Goldberg MF, Melia M, et al. A phase III, multicenter, randomized, placebo-controlled clinical trial of topical aminocaproic acid (Caprogel) in the management of traumatic hyphema. Ophthalmology 2003;110:2106-12. DOI 10.1016/S0161-6420(03)00866-2
45. Crouch ER Jr, Williams PB, Gray MK, Crouch ER, Chames M. Topical aminocaproic acid in the treatment of traumatic hyphema. Arch Ophthalmol 1997;115:1106-12.
46. Klepfish A, Berrebi A, Schattner A, Israel R. Intranasal tranexamic acid treatment for severe epistaxis in hereditary hemorrhagic telangiectasia. Arch Intern Med 2001;161:767.
47. Tibbelin A, Aust R, Bende M, et al. Effect of local tranexamic acid gel in the treatment of epistaxis. ORL J Otorhinolaryngol Relat Spec 1995;57:207-9.
48. Sabba C, Gallitelli M, Palasciano G. Efficacy of unusually high doses of tranexamic acid for the treatment of epistaxis in hereditary hemorrhagic telangiectasia. N Engl J Med 2001;345:926. DOI 10.1056/NEJM200109203451216
49. Jash DK. Epistaxis-topical use of epsilon-aminocaproic acid in its management. J Laryngol Otol 1973;87:895-8.
50. Berkstein A. Aminocaproic acid as a local hemostatic agent in epistaxis. Arch Otolaryngol 1971;93:456-7.
51. Mehraien A, Ghafari A, Mohammadi SS. Effect of topical aprotinin on early postoperative bleeding and ICU stay after coronary artery bypass graft surgeries. Pak J Biol Sci 2009;12:813-6.
52. Isgro F, Stanisch O, Kiessling AH, Gürler S, Hellstern P, Saggau W. Topical application of aprotinin in cardiac surgery. Perfusion 2002;17:347-51.
53. Mand'ák J, Lonsḱy V, Dominik J. Topical use of aprotinin in coronary artery bypass surgery. Acta Medica 1999;42:139-44.
54. O'Regan DJ, Giannopoulos N, Mediratta N, et al. Topical aprotinin in cardiac operations. Ann Thorac Surg 1994;58:778-81.
55. Tatar H, Ciçek S, Demirkiliç U, et al. Topical use of aprotinin in open heart operations. Ann Thorac Surg 1993;55:659-61.
56. Fawzy H, Elmistekawy E, Bonneau D, Latter D, Errett L. Can local application of tranexamic acid reduce post-coronary bypass surgery blood loss? A randomized controlled trial. J Cardiothorac Surg 2009;4:25. DOI 10.1186/1749-8090-4-25
57. Baric D, Biocina B, Unic D, et al. Topical use of antifibrinolytic agents reduces postoperative bleeding: a double-blind, prospective, randomized study. Eur J Cardiothorac Surg 2007;31:366-71. DOI 10.1016/j.ejcts.2006.12.003
58. Abul-Azm A, Abdullah KM. Effect of topical tranexamic acid in open heart surgery. Eur J Anaesthesiol 2006;23:380-4. DOI 10.1017/S0265021505001894
59. De Bonis M, Cavaliere F, Alessandrini F, et al. Topical use of tranexamic acid in coronary artery bypass operations: a double-blind, prospective, randomized, placebo-controlled study. J Thorac Cardiovasc Surg 2000;119:575-80.
60. Breda JR, Gurian DB, Breda AS, et al. Topical use of antifibrinolytic agent to reduce postoperative bleeding after coronary artery bypass surgery. Rev Bras Cir Cardiovasc 2009;24:341-5.
61. Spegar J, Vanek T, Snircova J, et al. Local and systemic application of tranexamic acid in heart valve surgery: a prospective, randomized, double blind LOST study. J Thromb Thrombolysis 2011;32:303-10. DOI 10.1007/s11239-011-0608-3
62. Wong J, Abrishami A, El Beheiry H, et al. Topical application of tranexamic acid reduces postoperative blood loss in total knee arthroplasty: a randomized, controlled trial. J Bone Joint Surg Am 2010;92:2503-13. DOI 10.2106/JBJS.I.01518
63. Krohn CD, Sørensen R, Lange JE, Riise R, Bjørnsen S, Brosstad F. Tranexamic acid given into the wound reduces postoperative blood loss by half in major orthopaedic surgery. Eur J Surg Suppl 2003;588:57-61.
64. Ishida K, Tsumura N, Kitagawa A, et al. Intra-articular injection of tranexamic acid reduces not only blood loss but also knee joint swelling after total knee arthroplasty. Int Orthop 2011;35:1639-45. DOI 10.1007/s00264-010-1205-3
65. Onodera T, Majima T, Sawaguchi N, Kasahara Y, Ishigaki T, Minami A. Risk of deep venous thrombosis in drain clamping with tranexamic acid and carbazochrome sodium sulfonate hydrate in total knee arthroplasty. J Arthroplasty 2012;27:105-8. DOI 10.1016/j.arth.2011.02.004
66. Akizuki S, Yasukawa Y, Takizawa T. A new method of hemostasis for cementless total knee arthroplasty. Bull Hosp Jt Dis 1997;56:222-4.
67. Athanasiadis T, Beule AG, Wormald PJ. Effects of topical antifibrinolytics in endoscopic sinus surgery: a pilot randomized controlled trial. Am J Rhinol 2007;21:737-42. DOI 10.2500/ajr.2007.21.3097
68. Khalil PN, Ismail M, Kalmar P, von Knobelsdorff G, Marx G. Activation of fibrinolysis in the pericardial cavity after cardiopulmonary bypass. Thromb Haemost 2004;92:568-74.
69. Tabuchi N, de Haan J, Boonstra PW, van Oeveren W. Activation of fibrinolysis in the pericardial cavity during cardiopulmonary bypass. J Thorac Cardiovasc Surg 1993;106:828-33.
70. Fremes SE, Wong BI, Lee E, et al. Metaanalysis of prophylactic drug treatment in the prevention of postoperative bleeding. Ann Thorac Surg 1994;58:1580-8.
71. Abrishami A, Chung F. Topical application of antifibrinolytic drugs for on-pump cardiac surgery: a systemic review and meta-analysis. Can J Anaesth 2009;56:202-12. DOI 10.1007/s12630-008-9038-x
72. Overbosch HC, Hart HC. Local application of epsilon-aminocaproic acid (E.A.C.A.) in the prevention of haemorrhage after tonsillectomy. J Laryngol Otol 1970;84:905-8.
73. Sarris I, Arafa A, Konaris L, Kadir RA. Topical use of tranexamic acid to control perioperative local bleeding in gynaecology patients with clotting disorders: two cases. Haemophilia 2007;13:115-6. DOI 10.1111/j.1365-2516.2006.01386.x
74. Coker N, Higgins DJ. Tranexamic acid applied topically to achieve haemostasis. Anaesthesia 2000;55:600-1.
75. Zhang YP, Trissel LA. Stability of aminocaproic acid injection admixtures in 5% dextrose injection and 0.9% sodium chloride injection. Int J Pharm Compound 1997;1:132-3.
76. Murray L, ed. 2011 Red book. Montvale, NJ: PDR Network, LCC, 2011.
77. US National Institutes of Health. Clinicaltrials. gov (accessed 2011 Jun 10).