High-dose Versus Low-dose Tranexamic Acid to Reduce Transfusion Requirements in Pediatric Scoliosis Surgery

Journal of Pediatric Orthopaedics

Volumn 37, Issue 8, 2017, Pages e552-e557

  Johnson, Daniel J ^a   Johnson, Christine C ^c   Goobie, Susan M ^d   Nami, Nina ^a   Wetzler, Joshua A ^a   Sponseller, Paul D ^b   Frank, Steven M ^a  

^a DEPARTMENT OF PATHOLOGY   (United States)

^b JOHNS HOPKINS UNIVERSITY   (United States)

^c HOSPITAL FOR SPECIAL SURGERY   (United States)

^d BOSTON CHILDREN S HOSPITAL   (United States)

Author keywords

adolescent idiopathic scoliosis; blood loss; dosing; posterior spinal fusion; scoliosis; tranexamic acid; transfusion

Indexed keywords

HEMOGLOBIN; TRANEXAMIC ACID; ANTIFIBRINOLYTIC AGENT;

ADOLESCENT; ADULT; ARTICLE; BLEEDING; COHORT ANALYSIS; CONTROLLED STUDY; DRUG DOSE COMPARISON; DRUG EFFICACY; DRUG MEGADOSE; ELECTRONIC MEDICAL RECORD; ERYTHROCYTE TRANSFUSION; ESTIMATED BLOOD LOSS; FEMALE; HEALTH HAZARD; HOSPITALIZATION; HUMAN; IDIOPATHIC SCOLIOSIS; LOADING DRUG DOSE; LOW DRUG DOSE; MAINTENANCE THERAPY; MAJOR CLINICAL STUDY; MALE; MATHEMATICAL ANALYSIS; MORBIDITY; PEDIATRICS; PEROPERATIVE COMPLICATION; PRIORITY JOURNAL; RETROSPECTIVE STUDY; SPINE FUSION; SURGEON; BLOOD TRANSFUSION; CHILD; DOSE RESPONSE; OPERATIVE BLOOD LOSS; SCOLIOSIS; TREATMENT OUTCOME;

ADOLESCENT; ANTIFIBRINOLYTIC AGENTS; BLOOD LOSS, SURGICAL; BLOOD TRANSFUSION; CHILD; DOSE-RESPONSE RELATIONSHIP, DRUG; FEMALE; HUMANS; MALE; RETROSPECTIVE STUDIES; SCOLIOSIS; SPINAL FUSION; TRANEXAMIC ACID; TREATMENT OUTCOME;

EID: 85033717211     PISSN: 02716798     EISSN: 15392570     Source Type: Journal    
DOI: 10.1097/BPO.0000000000000820     Document Type: Article

References (28)

1. Hresko MT. Clinical practice. Idiopathic scoliosis in adolescents. N Engl J Med. 2013;368:834-841.
2. Grant JA, Howard J, Luntley J, et al. Perioperative blood transfusion requirements in pediatric scoliosis surgery: the efficacy of tranexamic acid. J Pediatr Orthop. 2009;29:300-304.
3. Neilipovitz DT, Murto K, Hall L, et al. A randomized trial of tranexamic acid to reduce blood transfusion for scoliosis surgery. Anesth Analg. 2001;93:82-87.
4. Sethna NF, Zurakowski D, Brustowicz RM, et al. Tranexamic acid reduces intraoperative blood loss in pediatric patients undergoing scoliosis surgery. Anesthesiology. 2005;102:727-732.
5. McLeod LM, French B, Flynn JM, et al. Antifibrinolytic use and blood transfusions in pediatric scoliosis surgeries performed at US Children's Hospitals. J Spinal Disord Tech. 2015;28: E460-E466.
6. Basques BA, Anandasivam NS, Webb ML, et al. Risk factors for blood transfusion with primary posterior lumbar fusion. Spine (Phila Pa 1976). 2015;40:1792-1797.
7. Woods BI, Rosario BL, Chen A, et al. The association between perioperative allogeneic transfusion volume and postoperative infection in patients following lumbar spine surgery. J Bone Joint Surg Am. 2013;95:2105-2110.
8. Janssen SJ, Braun Y, Wood KB, et al. Allogeneic blood transfusions and postoperative infections after lumbar spine surgery. Spine J. 2015;15:901-909.
9. Goodnough LT. Risks of blood transfusion. Crit Care Med. 2003; 31:S678-S686.
10. Rohde JM, Dimcheff DE, Blumberg N, et al. Health care-associated infection after red blood cell transfusion: a systematic review and meta-analysis. JAMA. 2014;311:1317-1326.
11. Faraoni D, Goobie SM. New insights about the use of tranexamic acid in children undergoing cardiac surgery: from pharmacokinetics to pharmacodynamics. Anesth Analg. 2013;117:760-762.
12. Goobie SM, Meier PM, Pereira LM, et al. Efficacy of tranexamic acid in pediatric craniosynostosis surgery: a double-blind, placebocontrolled trial. Anesthesiology. 2011;114:862-871.
13. Hiippala ST, Strid LJ, Wennerstrand MI, et al. Tranexamic acid radically decreases blood loss and transfusions associated with total knee arthroplasty. Anesth Analg. 1997;84:839-844.
14. Ducloy-Bouthors AS, Susen S, Wong CA, et al. Medical advances in the treatment of postpartum hemorrhage. Anesth Analg. 2014;119: 1140-1147.
15. Shapiro F, Zurakowski D, Sethna NF. Tranexamic acid diminishes intraoperative blood loss and transfusion in spinal fusions for duchenne muscular dystrophy scoliosis. Spine (Phila Pa 1976). 2007;32:2278-2283.
16. Dhawale AA, Shah SA, Sponseller PD, et al. Are antifibrinolytics helpful in decreasing blood loss and transfusions during spinal fusion surgery in children with cerebral palsy scoliosis? Spine (Phila Pa 1976). 2012;37:E549-E555.
17. Yagi M, Hasegawa J, Nagoshi N, et al. Does the intraoperative tranexamic acid decrease operative blood loss during posterior spinal fusion for treatment of adolescent idiopathic scoliosis? Spine (Phila Pa 1976). 2012;37:E1336-E1342.
18. Ng BK, Chau WW, Hung AL, et al. Use of Tranexamic Acid (TXA) on reducing blood loss during scoliosis surgery in Chinese adolescents. Scoliosis. 2015;10:28-33.
19. Frank SM, Savage WJ, Rothschild JA, et al. Variability in blood and blood component utilization as assessed by an anesthesia information management system. Anesthesiology. 2012;117:99-106.
20. Frank SM, Wick EC, Dezern AE, et al. Risk-adjusted clinical outcomes in patients enrolled in a bloodless program. Transfusion. 2014;54:2668-2677.
21. Johnson DJ, Scott AV, Barodka VM, et al. Morbidity and mortality after high-dose transfusion. Anesthesiology. 2016;124:387-395.
22. Lykissas MG, Crawford AH, Chan G, et al. The effect of tranexamic acid in blood loss and transfusion volume in adolescent idiopathic scoliosis surgery: a single-surgeon experience. J Child Orthop. 2013;7:245-249.
23. Xu C, Wu A, Yue Y. Which is more effective in adolescent idiopathic scoliosis surgery: batroxobin, tranexamic acid or a combination? Arch Orthop Trauma Surg. 2012;132:25-31.
24. Verma K, Errico T, Diefenbach C, et al. The relative efficacy of antifibrinolytics in adolescent idiopathic scoliosis: a prospective randomized trial. J Bone Joint Surg Am. 2014;96:e80.
25. Farrokhi MR, Kazemi AP, Eftekharian HR, et al. Efficacy of prophylactic low dose of tranexamic acid in spinal fixation surgery: a randomized clinical trial. J Neurosurg Anesthesiol. 2011;23:290-296.
26. Bednar DA, Bednar VA, Chaudhary A, et al. Tranexamic acid for hemostasis in the surgical treatment of metastatic tumors of the spine. Spine (Phila Pa 1976). 2006;31:954-957.
27. Khurana A, Guha A, Saxena N, et al. Comparison of aprotinin and tranexamic acid in adult scoliosis correction surgery. Eur Spine J. 2012;21:1121-1126.
28. Krohn CD, Sorensen R, Lange JE, et al. Tranexamic acid given into the wound reduces postoperative blood loss by half in major orthopaedic surgery. Eur J Surg Suppl. 2003:57-61.