Impact of tranexamic acid use on blood loss and transfusion rates following femoral varus derotational osteotomy in children with cerebral palsy

被引:15
|
作者
Nazareth, A. [1 ,2 ]
Shymon, S. J. [3 ]
Andras, L. [1 ,4 ]
Goldstein, R. Y. [1 ,2 ]
Kay, R. M. [1 ,2 ]
机构
[1] Univ Southern Calif, Keck Sch Med, Los Angeles, CA USA
[2] Childrens Hosp Los Angeles, Childrens Orthopaed Ctr, 4650 Sunset Blvd,M-S 69, Los Angeles, CA 90027 USA
[3] Harbor UCLA Med Ctr, Dept Orthopaed Surg, Torrance, CA 90509 USA
[4] Childrens Hosp Los Angeles, Dept Anesthesiol, Los Angeles, CA 90027 USA
关键词
cerebral palsy; tranexamic acid; proximal femoral varus derotational osteotomy; TOTAL KNEE ARTHROPLASTY; UNITED-STATES; HIP; RECONSTRUCTION; SCOLIOSIS; SURGERY;
D O I
10.1302/1863-2548.13.180143
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
摘要
Purpose Previous studies have established the safety and efficacy of tranexamic acid (TXA) in reducing blood loss after total joint arthroplasty and spinal fusion surgery; however, literature regarding the effectiveness of intraoperative TXA in children with cerebral palsy (CP) is limited. The aim of this study was to investigate the safety and efficacy of intraoperative TXA in reducing blood loss and transfusion requirements for children with CP undergoing a proximal femoral varus derotational osteotomy (VDRO). Methods This is a retrospective review of 258 children with CP who underwent VDRO performed at the author's institution between 2004 and 2017. In all, 36 subjects underwent VDRO surgery with administration of intravenous TXA and 222 subjects underwent VDRO without administration of TXA. Outcome measures including blood loss, transfusion requirements and venous thromboembolic events were compared between groups using t-tests and chi-squared tests. Results No significant differences were seen in the rates of transfusion between groups for the entire hospitalization (TXA group: 11.1% versus No TXA group: 19.8%), intraoperatively (TXA: 2.8% versus No TXA: 9.0%) or postoperatively (TXA: 8.3% versus No TXA: 14.4%). Intraoperative estimated blood loss (TXA: 144.4 mL versus No TXA: 159.0 mL) and percentage blood loss (TXA: 8.9% versus No TXA: 9.2%) were similar between groups. No major thromboembolic complications events occurred in either group. Conclusion The use of TXA was not associated with thromboembolic complications in this series of children with CP undergoing VDRO surgery. Though there was a trend toward lower rates of intraoperative and postoperative blood transfusion with TXA use in these patients, the differences were not significant, possibly due to low estimated blood loss in both groups and sample size.
引用
收藏
页码:190 / 195
页数:6
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