Tranexamic Acid Applications in Surgical Hemostasis
Summary
Tranexamic acid is a synthetic lysine analogue that exerts its haemostatic effect by blocking lysine-binding sites on plasminogen, thereby attenuating fibrinolysis and stabilising clot formation. Its versatility has been demonstrated across a broad spectrum of surgical specialties, including orthopaedic, spinal, cardiovascular and obstetric procedures. By reducing intraoperative and postoperative blood loss, tranexamic acid diminishes the need for transfusion, lowers the risk of transfusion-related complications and contributes to more efficient resource utilisation. Global implementation has been driven by robust safety data, which indicate a neutral or minimal impact on thromboembolic risk when administered within established dosing regimens. Current research priorities focus on optimising timing, dosing strategies and routes of administration to maximise benefit in diverse patient populations, including those in low-resource environments.
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Tranexamic Acid Applications in Surgical Hemostasis publication trend
The graph below shows the total number of articles in tranexamic acid applications in surgical hemostasis across all publications each year (not limited to Nature Index journals).
Technical terms
Fibrinolysis: The physiological process of enzymatic breakdown of fibrin clots during wound healing.
Antifibrinolytic agent: A drug that inhibits the enzymatic degradation of fibrin to stabilise blood clots.
Thromboembolic event: Obstruction of a blood vessel by a clot that has travelled from its site of formation.
Allogeneic transfusion: Administration of blood products collected from a donor to a different recipient.
Viscoelastic assay: A dynamic laboratory test measuring clot formation and breakdown in whole blood samples.
References
- Tranexamic acid attenuates inflammatory response in cardiopulmonary bypass surgery through blockade of fibrinolysis: a case control study followed by a randomized double-blind controlled trial. Critical Care (2007).
- Tranexamic acid and the reduction of blood loss in total knee and hip arthroplasty: a meta-analysis. BMC Research Notes (2013).
- Transfusions and blood loss in total hip and knee arthroplasty: a prospective observational study. Journal of Orthopaedic Surgery and Research (2015).
- What concentration of tranexamic acid is needed to inhibit fibrinolysis? A systematic review of pharmacodynamics studies. Blood Coagulation & Fibrinolysis (2019).
- Systematic Review and Meta-Analysis of Perioperative Intravenous Tranexamic Acid Use in Spinal Surgery. PLOS ONE (2013).
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