Association of Intravenous Tranexamic Acid With Thromboembolic Events and Mortality | Acute Coronary Syndromes | JN Learning | AMA Ed Hub [Skip to Content]
[Skip to Content Landing]

Association of Intravenous Tranexamic Acid With Thromboembolic Events and MortalityA Systematic Review, Meta-analysis, and Meta-regression

Educational Objective To identify the extent to which tranexamic acid is associated with thromboembolic events in patients of all ages and any medical discipline.
1 Credit CME
Key Points

Question  Is intravenous administration of tranexamic acid associated with thromboembolic events in patients of all ages and of any medical discipline?

Findings  In this systematic review and meta-analysis of 216 studies of 125 550 patients undergoing surgical procedures and receiving either intravenous administration of tranexamic acid or placebo or no treatment, 1020 (2.1%) thromboembolic events in the tranexamic acid group and 900 (2.0%) total thromboembolic events in the control group were found. There was no increased risk of any thromboembolic event in patients of all medical disciplines.

Meaning  These results clarify whether vascular occlusive events are associated with administration of tranexamic acid.

Abstract

Importance  Tranexamic acid (TXA) is an efficient antifibrinolytic agent; however, concerns remain about the potential adverse effects, particularly vascular occlusive events, that may be associated with its use.

Objective  To examine the association between intravenous TXA and total thromboembolic events (TEs) and mortality in patients of all ages and of any medical disciplines.

Data Source  Cochrane Central Register of Controlled Trials and MEDLINE were searched for eligible studies investigating intravenous TXA and postinterventional outcome published between 1976 and 2020.

Study Selection  Randomized clinical trials comparing intravenous TXA with placebo/no treatment. The electronic database search yielded a total of 782 studies, and 381 were considered for full-text review. Included studies were published in English, German, French, and Spanish. Studies with only oral or topical tranexamic administration were excluded.

Data Extraction and Synthesis  Meta-analysis, subgroup and sensitivity analysis, and meta-regression were performed. This study followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) reporting guideline.

Main Outcomes and Measures  Vascular occlusive events and mortality.

Results  A total of 216 eligible trials including 125 550 patients were analyzed. Total TEs were found in 1020 (2.1%) in the group receiving TXA and 900 (2.0%) in the control group. This study found no association between TXA and risk for total TEs (risk difference = 0.001; 95% CI, −0.001 to 0.002; P = .49) for venous thrombosis, pulmonary embolism, venous TEs, myocardial infarction or ischemia, and cerebral infarction or ischemia. Sensitivity analysis using the risk ratio as an effect measure with (risk ratio = 1.02; 95% CI, 0.94-1.11; P = .56) and without (risk ratio = 1.03; 95% CI, 0.95-1.12; P = .52) studies with double-zero events revealed robust effect size estimates. Sensitivity analysis with studies judged at low risk for selection bias showed similar results. Administration of TXA was associated with a significant reduction in overall mortality and bleeding mortality but not with nonbleeding mortality. In addition, an increased risk for vascular occlusive events was not found in studies including patients with a history of thromboembolism. Comparison of studies with sample sizes of less than or equal to 99 (risk difference = 0.004; 95% CI, −0.006 to 0.014; P = .40), 100 to 999 (risk difference = 0.004; 95% CI, −0.003 to 0.011; P = .26), and greater than or equal to 1000 (risk difference = −0.001; 95% CI, −0.003 to 0.001; P = .44) showed no association between TXA and incidence of total TEs. Meta-regression of 143 intervention groups showed no association between TXA dosing and risk for venous TEs (risk difference, −0.005; 95% CI, −0.021 to 0.011; P = .53).

Conclusions and Relevance  Findings from this systematic review and meta-analysis of 216 studies suggested that intravenous TXA, irrespective of dosing, is not associated with increased risk of any TE. These results help clarify the incidence of adverse events associated with administration of intravenous TXA and suggest that TXA is safe for use with undetermined utility for patients receiving neurological care.

Sign in to take quiz and track your certificates

Buy This Activity

JN Learning™ is the home for CME and MOC from the JAMA Network. Search by specialty or US state and earn AMA PRA Category 1 CME Credit™ from articles, audio, Clinical Challenges and more. Learn more about CME/MOC

Article Information

Accepted for Publication: January 14, 2021.

Published Online: April 14, 2021. doi:10.1001/jamasurg.2021.0884

Corresponding Author: Patrick Meybohm, MD, Department of Anaesthesiology, Intensive Care, Emergency and Pain Medicine, University Hospital Wuerzburg, Oberduerrbacher Str 6, 97080 Wuerzburg, Germany (meybohm_p@ukw.de).

Author Contributions: Dr Meybohm had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. Drs Choorapoikayil and Meybohm contributed equally to this work. Ms Taeuber and Drs Meybohm and Choorapoikayil are guarantors.

Concept and design: Taeuber, Neef, Kranke, Choorapoikayil, Meybohm.

Acquisition, analysis, or interpretation of data: Taeuber, Weibel, Herrmann, Schlesinger, Kranke, Messroghli, Zacharowski, Choorapoikayil, Meybohm.

Drafting of the manuscript: Taeuber, Kranke, Choorapoikayil, Meybohm.

Critical revision of the manuscript for important intellectual content: All authors.

Statistical analysis: Taeuber, Weibel, Herrmann, Kranke, Choorapoikayil, Meybohm.

Administrative, technical, or material support: Kranke.

Supervision: Kranke, Zacharowski, Choorapoikayil, Meybohm.

Conflict of Interest Disclosures: Dr Kranke reported other support from FreseniusKabi speakers fee, personal fees from TevaRatiopharm, and other support from CSL Behring speakers fee outside the submitted work. Dr Zacharowski reported grants from B. Braun, grants from Fresenius, grants from CSL Behring, and grants from Vifor outside the submitted work. Dr Meybohm reported other support from B Braun Melsungen for the implementation of Frankfurt's Patient Blood Management program, other support from CSL Behring for the implementation of Frankfurt's Patient Blood Management program, other support from Fresenius Kabi for the implementation of Frankfurt's Patient Blood Management program, and other support from Vifor Pharma for the implementation of Frankfurt's Patient Blood Management program during the conduct of the study; other support from B Braun Melsungen honoraria for scientific lectures, other support from CSL Behring honoraria for scientific lectures, other support from Fresenius Kabi honoraria for scientific lectures, and other support from Vifor Pharma honoraria for scientific lectures outside the submitted work. No other disclosures were reported.

Additional Contributions: We thank Elisabeth Adam, MD, and Florian Piekarski, MD, from University Hospital Frankfurt for critical discussion. No compensation was received.

References
1.
Spence  J , LeManach  Y , Chan  MTV ,  et al; Vascular Events in Noncardiac Surgery Patients Cohort Evaluation (VISION) Study Investigators.  Association between complications and death within 30 days after noncardiac surgery.   CMAJ. 2019;191(30):E830-E837. doi:10.1503/cmaj.190221PubMedGoogle ScholarCrossref
2.
Poeran  J , Rasul  R , Suzuki  S ,  et al.  Tranexamic acid use and postoperative outcomes in patients undergoing total hip or knee arthroplasty in the United States: retrospective analysis of effectiveness and safety.   BMJ. 2014;349:g4829. doi:10.1136/bmj.g4829 PubMedGoogle ScholarCrossref
3.
Ker  K , Edwards  P,  Perel  P , Shakur  H , Roberts  I .  Effect of tranexamic acid on surgical bleeding: systematic review and cumulative meta-analysis.   BMJ. 2012;344:e3054. doi:10.1136/bmj.e3054 PubMedGoogle Scholar
4.
Lin  Z , Xiaoyi  Z .  Tranexamic acid-associated seizures: a meta-analysis.   Seizure. 2016;36:70-73. doi:10.1016/j.seizure.2016.02.011 PubMedGoogle ScholarCrossref
5.
Lier  H , Maegele  M , Shander  A .  Tranexamic acid for acute hemorrhage: a narrative review of landmark studies and a critical reappraisal of its use over the last decade.   Anesth Analg. 2019;129(6):1574-1584. doi:10.1213/ANE.0000000000004389 PubMedGoogle ScholarCrossref
6.
Sprigg  N , Flaherty  K , Appleton  JP ,  et al; TICH-2 Investigators.  Tranexamic acid for hyperacute primary IntraCerebral Haemorrhage (TICH-2): an international randomised, placebo-controlled, phase 3 superiority trial.   Lancet. 2018;391(10135):2107-2115. doi:10.1016/S0140-6736(18)31033-X PubMedGoogle ScholarCrossref
7.
Morrison  JJ , Dubose  JJ , Rasmussen  TE , Midwinter  MJ .  Military Application of Tranexamic Acid in Trauma Emergency Resuscitation (MATTERs) Study.   Arch Surg. 2012;147(2):113-119. doi:10.1001/archsurg.2011.287PubMedGoogle ScholarCrossref
8.
Gruen  RL , Jacobs  IG , Reade  MC ; PATCH-Trauma Study.  Trauma and tranexamic acid.   Med J Aust. 2013;199(5):310-311. doi:10.5694/mja13.10747 PubMedGoogle ScholarCrossref
9.
Cole  E , Davenport  R , Willett  K , Brohi  K .  Tranexamic acid use in severely injured civilian patients and the effects on outcomes: a prospective cohort study.   Ann Surg. 2015;261(2):390-394. doi:10.1097/SLA.0000000000000717 PubMedGoogle ScholarCrossref
10.
Kozek-Langenecker  SA , Ahmed  AB , Afshari  A ,  et al.  Management of severe perioperative bleeding: guidelines from the European Society of Anaesthesiology: first update 2016.   Eur J Anaesthesiol. 2017;34(6):332-395. doi:10.1097/EJA.0000000000000630 PubMedGoogle ScholarCrossref
11.
American Society of Anesthesiologists Task Force on Perioperative Blood Management.  Practice guidelines for perioperative blood management: an updated report by the American Society of Anesthesiologists Task Force on Perioperative Blood Management.   Anesthesiology. 2015;122(2):241-275. doi:10.1097/ALN.0000000000000463 PubMedGoogle ScholarCrossref
12.
Rossaint  R , Bouillon  B , Cerny  V ,  et al.  The European guideline on management of major bleeding and coagulopathy following trauma: fourth edition.   Crit Care. 2016 12;20:100. doi:10.1186/s13054-016-1265-xGoogle Scholar
13.
Spahn  DR , Bouillon  B , Cerny  V ,  et al.  The European guideline on management of major bleeding and coagulopathy following trauma: fifth edition.   Crit Care. Published online March 27, 2019. doi:10.1186/s13054-019-2347-3Google Scholar
14.
Moher  D , Liberati  A , Tetzlaff  J , Altman  DG ; PRISMA Group.  Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement.   BMJ. 2009;339:b2535. doi:10.1136/bmj.b2535 PubMedGoogle ScholarCrossref
15.
Celebi  N , Celebioglu  B , Selcuk  M , Canbay  O , Karagoz  AH , Aypar  U .  The role of antifibrinolytic agents in gynecologic cancer surgery.   Saudi Med J. 2006;27(5):637-641.PubMedGoogle Scholar
16.
Gohel  M , Patel  P , Gupta  A , Desai  P .  Efficacy of tranexamic acid in decreasing blood loss during and after cesarean section: a randomized case controlled prospective study.   J Obstet Gynaecol India. 2007;57(3):227-230. https://jogi.co.in/may_june_2007/07_oa_efficacy.pdfGoogle Scholar
17.
Caglar  GS , Tasci  Y , Kayikcioglu  F , Haberal  A .  Intravenous tranexamic acid use in myomectomy: a prospective randomized double-blind placebo controlled study.   Eur J Obstet Gynecol Reprod Biol. 2008;137(2):227-231. doi:10.1016/j.ejogrb.2007.04.003 PubMedGoogle ScholarCrossref
18.
Sekhavat  L , Tabatabaii  A , Dalili  M , Farajkhoda  T , Tafti  AD .  Efficacy of tranexamic acid in reducing blood loss after cesarean section.   J Matern Fetal Neonatal Med. 2009;22(1):72-75. doi:10.1080/14767050802353580 PubMedGoogle ScholarCrossref
19.
Rashmi  PS , Sudha  TR , Prema  P , Rajashri  P , Vijayanath  V .  Role of tranexamic acid in reducing blood loss during and after cesarean section: a randomized case control prospective study.   J Med Res Pract. 2012;1(2):40-43.Google Scholar
20.
Ducloy-Bouthors  AS , Jude  B , Duhamel  A ,  et al; EXADELI Study Group.  High-dose tranexamic acid reduces blood loss in postpartum haemorrhage.   Crit Care. 2011;15(2):R117. doi:10.1186/cc10143 PubMedGoogle ScholarCrossref
21.
Gungorduk  K , Yıldırım  G , Asıcıoğlu  O , Gungorduk  OC , Sudolmus  S , Ark  C .  Efficacy of intravenous tranexamic acid in reducing blood loss after elective cesarean section: a prospective, randomized, double-blind, placebo-controlled study.   Am J Perinatol. 2011;28(3):233-240. doi:10.1055/s-0030-1268238 PubMedGoogle ScholarCrossref
22.
Movafegh  A , Eslamian  L , Dorabadi  A .  Effect of intravenous tranexamic acid administration on blood loss during and after cesarean delivery.   Int J Gynaecol Obstet. 2011;115(3):224-226. doi:10.1016/j.ijgo.2011.07.015 PubMedGoogle ScholarCrossref
23.
Gupta  K , Rastogi  B , Krishan  A , Gupta  A , Singh  VP , Agarwal  S .  The prophylactic role of tranexamic acid to reduce blood loss during radical surgery: a prospective study.   Anesth Essays Res. 2012;6(1):70-73. doi:10.4103/0259-1162.103378 PubMedGoogle ScholarCrossref
24.
Abdel-Aleem  H , Alhusaini  TK , Abdel-Aleem  MA , Menoufy  M , Gülmezoglu  AM .  Effectiveness of tranexamic acid on blood loss in patients undergoing elective cesarean section: randomized clinical trial.   J Matern Fetal Neonatal Med. 2013;26(17):1705-1709. doi:10.3109/14767058.2013.794210 PubMedGoogle ScholarCrossref
25.
Goswami  U , Sarangi  S , Gupta  S , Babbar  S .  Comparative evaluation of two doses of tranexamic acid used prophylactically in anemic parturients for lower segment cesarean section: a double-blind randomized case control prospective trial.   Saudi J Anaesth. 2013;7(4):427-431. doi:10.4103/1658-354X.121077 PubMedGoogle ScholarCrossref
26.
Gungorduk  K , Asıcıoğlu  O , Yıldırım  G , Ark  C , Tekirdağ  AI , Besımoglu  B .  Can intravenous injection of tranexamic acid be used in routine practice with active management of the third stage of labor in vaginal delivery? a randomized controlled study.   Am J Perinatol. 2013;30(5):407-413. doi:10.1097/01.ogx.0000436756.05118.cd PubMedGoogle Scholar
27.
Sentürk  MB , Cakmak  Y , Yildiz  G , Yildiz  P .  Tranexamic acid for cesarean section: a double-blind, placebo-controlled, randomized clinical trial.   Arch Gynecol Obstet. 2013;287(4):641-645. doi:10.1007/s00404-012-2624-8 PubMedGoogle ScholarCrossref
28.
Shahid  A , Khan  A .  Tranexamic acid in decreasing blood loss during and after caesarean section.   J Coll Physicians Surg Pak. 2013;23(7):459-462.PubMedGoogle Scholar
29.
Xu  J , Gao  W , Ju  Y .  Tranexamic acid for the prevention of postpartum hemorrhage after cesarean section: a double-blind randomization trial.   Arch Gynecol Obstet. 2013;287(3):463-468. doi:10.1007/s00404-012-2593-y PubMedGoogle ScholarCrossref
30.
Ghosh  A , Chaudhuri  P , Muhuri  B .  Efficacy of intravenous tranexamic acid before cesarean section in preventing post-partum hemorrhage-a prospective randomized double blind placebo controlled study.   Int J Biomed Res. 2014;5(4):4461-4464. https://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.680.9525&rep=rep1&type=pdfGoogle Scholar
31.
Lundin  ES , Johansson  T , Zachrisson  H ,  et al.  Single-dose tranexamic acid in advanced ovarian cancer surgery reduces blood loss and transfusions: double-blind placebo-controlled randomized multicenter study.   Acta Obstet Gynecol Scand. 2014;93(4):335-344. doi:10.1111/aogs.12333 PubMedGoogle ScholarCrossref
32.
Gobbur  VR , Shiragur  SS , Jhanwar  UR , Tehalia  MJ .  Efficacy of tranexamic acid in reducing blood loss during lower segment caesarean section.   Int J Reprod Contracept Obstet Gynecol. 2014;3(2):414-417. doi:10.5455/2320-1770.ijrcog20140626 Google ScholarCrossref
33.
Yehia  AH , Koleib  MH , Abdelazimab  IA , Atik  A .  Tranexamic acid reduces blood loss during and after cesarean section: a double blinded, randomized, controlled trial.   Asian Pac J Reprod. 2014;3(1):53-56. doi:10.1016/S2305-0500(14)60002-6Google ScholarCrossref
34.
Ahmed  MR , Sayed Ahmed  WA , Madny  EH , Arafa  AM , Said  MM .  Efficacy of tranexamic acid in decreasing blood loss in elective caesarean delivery.   J Matern Fetal Neonatal Med. 2015;28(9):1014-1018. doi:10.3109/14767058.2014.941283 PubMedGoogle ScholarCrossref
35.
Maged  AM , Helal  OM , Elsherbini  MM ,  et al.  A randomized placebo-controlled trial of preoperative tranexamic acid among women undergoing elective cesarean delivery.   Int J Gynaecol Obstet. 2015;131(3):265-268. doi:10.1016/j.ijgo.2015.05.027 PubMedGoogle ScholarCrossref
36.
Ngichabe  S , Obura  T , Stones  W .  Intravenous tranexamic acid as an adjunct haemostat to ornipressin during open myomectomy: a randomized double blind placebo controlled trial.   Ann Surg Innov Res. 2015;9:10. doi:10.1186/s13022-015-0017-y PubMedGoogle ScholarCrossref
37.
Ray  I , Bhattacharya  R , Chakraborty  S , Bagchi  C , Mukhopadhyay  S .  Role of intravenous tranexamic acid on caesarean blood loss: a prospective randomised study.   J Obstet Gynaecol India. 2016;66(suppl 1):347-352. doi:10.1007/s13224-016-0915-x PubMedGoogle ScholarCrossref
38.
Shaaban  MM , Ahmed  MR , Farhan  RE , Dardeer  HH .  Efficacy of tranexamic acid on myomectomy-associated blood loss in patients with multiple myomas: a randomized controlled clinical trial.   Reprod Sci. 2016;23(7):908-912. doi:10.1177/1933719115623646 PubMedGoogle ScholarCrossref
39.
Topsoee  MF , Bergholt  T , Ravn  P ,  et al.  Anti-hemorrhagic effect of prophylactic tranexamic acid in benign hysterectomy-a double-blinded randomized placebo-controlled trial.   Am J Obstet Gynecol. 2016;215(1):72.e1-72.e8. doi:10.1016/j.ajog.2016.01.184PubMedGoogle ScholarCrossref
40.
WOMAN Trial Collaborators.  Effect of early tranexamic acid administration on mortality, hysterectomy, and other morbidities in women with post-partum haemorrhage (WOMAN): an international, randomised, double-blind, placebo-controlled trial.   Lancet. 2017;389(10084):2105-2116. doi:10.1016/S0140-6736(17)30638-4 PubMedGoogle ScholarCrossref
41.
Shakur  H , Roberts  I , Bautista  R ,  et al; CRASH-2 Trial Collaborators.  Effects of tranexamic acid on death, vascular occlusive events, and blood transfusion in trauma patients with significant haemorrhage (CRASH-2): a randomised, placebo-controlled trial.   Lancet. 2010;376(9734):23-32. doi:10.1016/S0140-6736(10)60835-5PubMedGoogle ScholarCrossref
42.
Choi  WS , Irwin  MG , Samman  N .  The effect of tranexamic acid on blood loss during orthognathic surgery: a randomized controlled trial.   J Oral Maxillofac Surg. 2009;67(1):125-133. doi:10.1016/j.joms.2008.08.015 PubMedGoogle ScholarCrossref
43.
Alimian  M , Mohseni  M .  The effect of intravenous tranexamic acid on blood loss and surgical field quality during endoscopic sinus surgery: a placebo-controlled clinical trial.   J Clin Anesth. 2011;23(8):611-615. doi:10.1016/j.jclinane.2011.03.004 PubMedGoogle ScholarCrossref
44.
Sankar  D , Krishnan  R , Veerabahu  M , Vikraman  B .  Evaluation of the efficacy of tranexamic acid on blood loss in orthognathic surgery: a prospective, randomized clinical study.   Int J Oral Maxillofac Surg. 2012;41(6):713-717. doi:10.1016/j.ijom.2012.01.008 PubMedGoogle ScholarCrossref
45.
Dakir  A , Ramalingam  B , Ebenezer  V , Dhanavelu  P .  Efficacy of tranexamic acid in reducing blood loss during maxillofacial trauma surgery-a pilot study.   J Clin Diagn Res. 2014;8(5):ZC06-ZC08. doi:10.7860/JCDR/2014/8680.4313PubMedGoogle Scholar
46.
Nuhi  S , Goljanian Tabrizi  A , Zarkhah  L , Rashedi Ashrafi  B .  Impact of intravenous tranexamic acid on hemorrhage during endoscopic sinus surgery.   Iran J Otorhinolaryngol. 2015;27(82):349-354.PubMedGoogle Scholar
47.
Apipan  B , Rummasak  D , Narainthonsaenee  T .  The effect of different dosage regimens of tranexamic acid on blood loss in bimaxillary osteotomy: a randomized, double-blind, placebo-controlled study.   Int J Oral Maxillofac Surg. 2018;47(5):608-612. doi:10.1016/j.ijom.2017.10.007 PubMedGoogle ScholarCrossref
48.
Hiippala  S , Strid  L , Wennerstrand  M ,  et al.  Tranexamic acid (Cyklokapron) reduces perioperative blood loss associated with total knee arthroplasty.   Br J Anaesth. 1995;74(5):534-537. doi:10.1093/bja/74.5.534 PubMedGoogle ScholarCrossref
49.
Benoni  G , Fredin  H .  Fibrinolytic inhibition with tranexamic acid reduces blood loss and blood transfusion after knee arthroplasty: a prospective, randomised, double-blind study of 86 patients.   J Bone Joint Surg Br. 1996;78(3):434-440. doi:10.1302/0301-620X.78B3.0780434 PubMedGoogle ScholarCrossref
50.
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(4):839-844. doi:10.1213/00000539-199704000-00026 PubMedGoogle ScholarCrossref
51.
Jansen  AJ , Andreica  S , Claeys  M , D’Haese  J , Camu  F , Jochmans  K .  Use of tranexamic acid for an effective blood conservation strategy after total knee arthroplasty.   Br J Anaesth. 1999;83(4):596-601. doi:10.1093/bja/83.4.596 PubMedGoogle ScholarCrossref
52.
Benoni  G , Lethagen  S , Nilsson  P , Fredin  H .  Tranexamic acid, given at the end of the operation, does not reduce postoperative blood loss in hip arthroplasty.   Acta Orthop Scand. 2000;71(3):250-254. doi:10.1080/000164700317411834 PubMedGoogle ScholarCrossref
53.
Ekbäck  G , Axelsson  K , Ryttberg  L ,  et al.  Tranexamic acid reduces blood loss in total hip replacement surgery.   Anesth Analg. 2000;91(5):1124-1130. doi:10.1213/00000539-200011000-00014 PubMedGoogle ScholarCrossref
54.
Benoni  G , Fredin  H , Knebel  R , Nilsson  P .  Blood conservation with tranexamic acid in total hip arthroplasty: a randomized, double-blind study in 40 primary operations.   Acta Orthop Scand. 2001;72(5):442-448. doi:10.1080/000164701753532754 PubMedGoogle ScholarCrossref
55.
Engel  JM , Hohaus  T , Ruwoldt  R , Menges  T , Jürgensen  I , Hempelmann  G .  Regional hemostatic status and blood requirements after total knee arthroplasty with and without tranexamic acid or aprotinin.   Anesth Analg. 2001;92(3):775-780. doi:10.1213/00000539-200103000-00041 PubMedGoogle ScholarCrossref
56.
Neilipovitz  DT , Murto  K , Hall  L , Barrowman  NJ , Splinter  WM .  A randomized trial of tranexamic acid to reduce blood transfusion for scoliosis surgery.   Anesth Analg. 2001;93(1):82-87. doi:10.1097/00000539-200107000-00018 PubMedGoogle ScholarCrossref
57.
Tanaka  N , Sakahashi  H , Sato  E , Hirose  K , Ishima  T , Ishii  S .  Timing of the administration of tranexamic acid for maximum reduction in blood loss in arthroplasty of the knee.   J Bone Joint Surg Br. 2001;83(5):702-705. doi:10.1302/0301-620X.83B5.0830702 PubMedGoogle ScholarCrossref
58.
Veien  M , Sørensen  JV , Madsen  F , Juelsgaard  P .  Tranexamic acid given intraoperatively reduces blood loss after total knee replacement: a randomized, controlled study.   Acta Anaesthesiol Scand. 2002;46(10):1206-1211. doi:10.1034/j.1399-6576.2002.461007.x PubMedGoogle ScholarCrossref
59.
Good  L , Peterson  E , Lisander  B .  Tranexamic acid decreases external blood loss but not hidden blood loss in total knee replacement.   Br J Anaesth. 2003;90(5):596-599. doi:10.1093/bja/aeg111 PubMedGoogle ScholarCrossref
60.
Husted  H , Blønd  L , Sonne-Holm  S , Holm  G , Jacobsen  TW , Gebuhr  P .  Tranexamic acid reduces blood loss and blood transfusions in primary total hip arthroplasty: a prospective randomized double-blind study in 40 patients.   Acta Orthop Scand. 2003;74(6):665-669. doi:10.1080/00016470310018171 PubMedGoogle ScholarCrossref
61.
Garneti  N , Field  J .  Bone bleeding during total hip arthroplasty after administration of tranexamic acid.   J Arthroplasty. 2004;19(4):488-492. doi:10.1016/j.arth.2003.12.073 PubMedGoogle ScholarCrossref
62.
Lemay  E , Guay  J , Côté  C , Roy  A .  Tranexamic acid reduces the need for allogenic red blood cell transfusions in patients undergoing total hip replacement.   Can J Anaesth. 2004;51(1):31-37. doi:10.1007/BF03018543 PubMedGoogle ScholarCrossref
63.
Yamasaki  S , Masuhara  K , Fuji  T .  Tranexamic acid reduces blood loss after cementless total hip arthroplasty-prospective randomized study in 40 cases.   Int Orthop. 2004;28(2):69-73. doi:10.1007/s00264-003-0511-4 PubMedGoogle ScholarCrossref
64.
Zohar  E , Ellis  M , Ifrach  N , Stern  A , Sapir  O , Fredman  B .  The postoperative blood-sparing efficacy of oral versus intravenous tranexamic acid after total knee replacement.   Anesth Analg. 2004;99(6):1679-1683. doi:10.1213/01.ANE.0000136770.75805.19 PubMedGoogle ScholarCrossref
65.
Johansson  T , Pettersson  LG , Lisander  B .  Tranexamic acid in total hip arthroplasty saves blood and money: a randomized, double-blind study in 100 patients.   Acta Orthop. 2005;76(3):314-319. doi:10.1080/00016470510030751 PubMedGoogle ScholarCrossref
66.
Niskanen  RO , Korkala  OL .  Tranexamic acid reduces blood loss in cemented hip arthroplasty: a randomized, double-blind study of 39 patients with osteoarthritis.   Acta Orthop. 2005;76(6):829-832. doi:10.1080/17453670510045444 PubMedGoogle ScholarCrossref
67.
Camarasa  MA , Ollé  G , Serra-Prat  M ,  et al.  Efficacy of aminocaproic, tranexamic acids in the control of bleeding during total knee replacement: a randomized clinical trial.   Br J Anaesth. 2006;96(5):576-582. doi:10.1093/bja/ael057 PubMedGoogle ScholarCrossref
68.
Orpen  NM , Little  C , Walker  G , Crawfurd  EJ .  Tranexamic acid reduces early post-operative blood loss after total knee arthroplasty: a prospective randomised controlled trial of 29 patients.   Knee. 2006;13(2):106-110. doi:10.1016/j.knee.2005.11.001 PubMedGoogle ScholarCrossref
69.
Claeys  MA , Vermeersch  N , Haentjens  P .  Reduction of blood loss with tranexamic acid in primary total hip replacement surgery.   Acta Chir Belg. 2007;107(4):397-401. doi:10.1080/00015458.2007.11680081 PubMedGoogle ScholarCrossref
70.
Molloy  DO , Archbold  HA , Ogonda  L , McConway  J , Wilson  RK , Beverland  DE .  Comparison of topical fibrin spray and tranexamic acid on blood loss after total knee replacement: a prospective, randomised controlled trial.   J Bone Joint Surg Br. 2007;89(3):306-309. doi:10.1302/0301-620X.89B3.17565 PubMedGoogle ScholarCrossref
71.
Sadeghi  M , Mehr-Aein  A .  Does a single bolus dose of tranexamic acid reduce blood loss and transfusion requirements during hip fracture surgery? a prospective randomized double blind study in 67 patients.   Acta Med Iran. 2007;45(6):437-442. https://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.514.38&rep=rep1&type=pdfGoogle Scholar
72.
Alvarez  JC , Santiveri  FX , Ramos  I , Vela  E , Puig  L , Escolano  F .  Tranexamic acid reduces blood transfusion in total knee arthroplasty even when a blood conservation program is applied.   Transfusion. 2008;48(3):519-525. doi:10.1111/j.1537-2995.2007.01564.x PubMedGoogle ScholarCrossref
73.
Elwatidy  S , Jamjoom  Z , Elgamal  E , Zakaria  A , Turkistani  A , El-Dawlatly  A .  Efficacy and safety of prophylactic large dose of tranexamic acid in spine surgery: a prospective, randomized, double-blind, placebo-controlled study.   Spine (Phila Pa 1976). 2008;33(24):2577-2580. doi:10.1097/BRS.0b013e318188b9c5 PubMedGoogle ScholarCrossref
74.
Wong  J , El Beheiry  H , Rampersaud  YR ,  et al.  Tranexamic acid reduces perioperative blood loss in adult patients having spinal fusion surgery.   Anesth Analg. 2008;107(5):1479-1486. doi:10.1213/ane.0b013e3181831e44 PubMedGoogle ScholarCrossref
75.
Kakar  PN , Gupta  N , Govil  P , Shah  V .  Efficacy and safety of tranexamic acid in control of bleeding following TKR: a randomized clinical trial.   Indian J Anaesth. 2009;53(6):667-671.PubMedGoogle Scholar
76.
Jalaeian  TR , Mashhadinezhad  H , Sharifian Attar  A , Peivandi  A .  The effect of intravenous tranexamic acid on blood loss in lumbar hernial disc resection under inhalation and total intravenous anesthesia.   Iran Red Crescent Med J. 2009;11(3):265-270. https://www.researchgate.net/profile/Arash-Peivandi-Yazdi/publication/26627438_The_Effect_of_Intravenous_Tranexamic_Acid_on_Blood_Loss_in_Lumbar_Hernial_Disc_Resection_under_Inhalation_and_Total_Intravenous_Anesthesia/links/004635247e26dc347d000000/The-Effect-of-Intravenous-Tranexamic-Acid-on-Blood-Loss-in-Lumbar-Hernial-Disc-Resection-under-Inhalation-and-Total-Intravenous-Anesthesia.pdfGoogle Scholar
77.
Kazemi  SM , Mosaffa  F , Eajazi  A ,  et al.  The effect of tranexamic acid on reducing blood loss in cementless total hip arthroplasty under epidural anesthesia.   Orthopedics. 2010;33(1):17. doi:10.3928/01477447-20091124-30 PubMedGoogle Scholar
78.
Zufferey  PJ , Miquet  M , Quenet  S ,  et al; Tranexamic Acid in Hip-Fracture Surgery (THIF) Study.  Tranexamic acid in hip fracture surgery: a randomized controlled trial.   Br J Anaesth. 2010;104(1):23-30. doi:10.1093/bja/aep314PubMedGoogle ScholarCrossref
79.
Charoencholvanich  K , Siriwattanasakul  P .  Tranexamic acid reduces blood loss and blood transfusion after TKA: a prospective randomized controlled trial.   Clin Orthop Relat Res. 2011;469(10):2874-2880. doi:10.1007/s11999-011-1874-2 PubMedGoogle ScholarCrossref
80.
Farrokhi  MR , Kazemi  AP , Eftekharian  HR , Akbari  K .  Efficacy of prophylactic low dose of tranexamic acid in spinal fixation surgery: a randomized clinical trial.   J Neurosurg Anesthesiol. 2011;23(4):290-296. doi:10.1097/ANA.0b013e31822914a1 PubMedGoogle ScholarCrossref
81.
Lin  PC , Hsu  CH , Chen  WS , Wang  JW .  Does tranexamic acid save blood in minimally invasive total knee arthroplasty?   Clin Orthop Relat Res. 2011;469(7):1995-2002. doi:10.1007/s11999-011-1789-y PubMedGoogle ScholarCrossref
82.
MacGillivray  RG , Tarabichi  SB , Hawari  MF , Raoof  NT .  Tranexamic acid to reduce blood loss after bilateral total knee arthroplasty: a prospective, randomized double blind study.   J Arthroplasty. 2011;26(1):24-28. doi:10.1016/j.arth.2009.11.013 PubMedGoogle ScholarCrossref
83.
Malhotra  R , Kumar  V , Garg  B .  The use of tranexamic acid to reduce blood loss in primary cementless total hip arthroplasty.   Eur J Orthop Surg Traumatol. 2011;21:101-104. doi:10.1007/s00590-010-0671-zGoogle ScholarCrossref
84.
Suksamosorn  P , Suarjui  J , Lewsirirat  S .  Tranexamic acid in reducing perioperative blood loss in lumbar spinal stenosis surgery: a double-blind randomized controlled trial.   Thai J Ortho Surg. 2011;35(3-4):1-7. https://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.985.6372&rep=rep1&type=pdfGoogle Scholar
85.
Tsutsumimoto  T , Shimogata  M , Ohta  H , Yui  M , Yoda  I , Misawa  H .  Tranexamic acid reduces perioperative blood loss in cervical laminoplasty: a prospective randomized study.   Spine (Phila Pa 1976). 2011;36(23):1913-1918. doi:10.1097/BRS.0b013e3181fb3a42 PubMedGoogle ScholarCrossref
86.
Chareancholvanich  K , Siriwattanasakul  P , Narkbunnam  R , Pornrattanamaneewong  C .  Temporary clamping of drain combined with tranexamic acid reduce blood loss after total knee arthroplasty: a prospective randomized controlled trial.   BMC Musculoskelet Disord. 2012;13:124. doi:10.1186/1471-2474-13-124 PubMedGoogle ScholarCrossref
87.
Imai  N , Dohmae  Y , Suda  K , Miyasaka  D , Ito  T , Endo  N .  Tranexamic acid for reduction of blood loss during total hip arthroplasty.   J Arthroplasty. 2012;27(10):1838-1843. doi:10.1016/j.arth.2012.04.024 PubMedGoogle ScholarCrossref
88.
Lin  PC , Hsu  CH , Huang  CC , Chen  WS , Wang  JW .  The blood-saving effect of tranexamic acid in minimally invasive total knee replacement: is an additional pre-operative injection effective?   J Bone Joint Surg Br. 2012;94(7):932-936. doi:10.1302/0301-620X.94B7.28386 PubMedGoogle ScholarCrossref
89.
Raviraj  A , Anand  A , Chakravarthy  M , Kumarswamy  S , Prabhu  A , Pai  S .  Tranexamic acid reduces blood loss in simultaneous bilateral total knee arthroplasty: a randomized control trial.   Eur J Orthop Surg Traumatol. 2012;22(5):381-386. doi:10.1007/s00590-011-0845-3Google ScholarCrossref
90.
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(1):25-31. doi:10.1007/s00402-011-1390-6 PubMedGoogle ScholarCrossref
91.
Aguilera  X , Martinez-Zapata  MJ , Bosch  A ,  et al.  Efficacy and safety of fibrin glue and tranexamic acid to prevent postoperative blood loss in total knee arthroplasty: a randomized controlled clinical trial.   J Bone Joint Surg Am. 2013;95(22):2001-2007. doi:10.2106/JBJS.L.01182 PubMedGoogle ScholarCrossref
92.
Gautam  VK , Sambandam  B , Singh  S , Gupta  P , Gupta  R , Maini  L .  The role of tranexamic acid in reducing blood loss in total knee replacement.   J Clin Orthop Trauma. 2013;4(1):36-39. doi:10.1016/j.jcot.2013.01.007 PubMedGoogle ScholarCrossref
93.
Lee  SH , Cho  KY , Khurana  S , Kim  KI .  Less blood loss under concomitant administration of tranexamic acid and indirect factor Xa inhibitor following total knee arthroplasty: a prospective randomized controlled trial.   Knee Surg Sports Traumatol Arthrosc. 2013;21(11):2611-2617. doi:10.1007/s00167-012-2213-1 PubMedGoogle ScholarCrossref
94.
Lee  YC , Park  SJ , Kim  JS , Cho  CH .  Effect of tranexamic acid on reducing postoperative blood loss in combined hypotensive epidural anesthesia and general anesthesia for total hip replacement.   J Clin Anesth. 2013;25(5):393-398. doi:10.1016/j.jclinane.2013.02.006 PubMedGoogle ScholarCrossref
95.
Seo  JG , Moon  YW , Park  SH , Kim  SM , Ko  KR .  The comparative efficacies of intra-articular and intravenous tranexamic acid for reducing blood loss during total knee arthroplasty.   Knee Surg Sports Traumatol Arthrosc. 2013;21(8):1869-1874. doi:10.1007/s00167-012-2079-2 PubMedGoogle ScholarCrossref
96.
Vijay  BS , Bedi  V , Mitra  S , Das  B .  Role of tranexamic acid in reducing postoperative blood loss and transfusion requirement in patients undergoing hip and femoral surgeries.   Saudi J Anaesth. 2013;7(1):29-32. doi:10.4103/1658-354X.109803 PubMedGoogle ScholarCrossref
97.
Wang  Q , Liu  J , Fan  R ,  et al.  Tranexamic acid reduces postoperative blood loss of degenerative lumbar instability with stenosis in posterior approach lumbar surgery: a randomized controlled trial.   Eur Spine J. 2013;22(9):2035-2038. doi:10.1007/s00586-013-2836-z PubMedGoogle ScholarCrossref
98.
Bidolegui  F , Arce  G , Lugones  A , Pereira  S , Vindver  G .  Tranexamic acid reduces blood loss and transfusion in patients undergoing total knee arthroplasty without tourniquet: a prospective randomized controlled trial.   Open Orthop J. 2014;8:250-254. doi:10.2174/1874325001408010250 PubMedGoogle ScholarCrossref
99.
Emara  WM , Moez  KK , Elkhouly  AH .  Topical versus intravenous tranexamic acid as a blood conservation intervention for reduction of post-operative bleeding in hemiarthroplasty.   Anesth Essays Res. 2014;8(1):48-53. doi:10.4103/0259-1162.128908 PubMedGoogle ScholarCrossref
100.
Kim  TK , Chang  CB , Kang  YG ,  et al.  Clinical value of tranexamic acid in unilateral and simultaneous bilateral TKAs under a contemporary blood-saving protocol: a randomized controlled trial.   Knee Surg Sports Traumatol Arthrosc. 2014;22(8):1870-1878. doi:10.1007/s00167-013-2492-1 PubMedGoogle ScholarCrossref
101.
Oremus  K , Sostaric  S , Trkulja  V , Haspl  M .  Influence of tranexamic acid on postoperative autologous blood retransfusion in primary total hip and knee arthroplasty: a randomized controlled trial.   Transfusion. 2014;54(1):31-41. doi:10.1111/trf.12224 PubMedGoogle ScholarCrossref
102.
Sarzaeem  MM , Razi  M , Kazemian  G , Moghaddam  ME , Rasi  AM , Karimi  M .  Comparing efficacy of three methods of tranexamic acid administration in reducing hemoglobin drop following total knee arthroplasty.   J Arthroplasty. 2014;29(8):1521-1524. doi:10.1016/j.arth.2014.02.031 PubMedGoogle ScholarCrossref
103.
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(10):e80. doi:10.2106/JBJS.L.00008 PubMedGoogle Scholar
104.
Wei  W , Wei  B .  Comparison of topical and intravenous tranexamic acid on blood loss and transfusion rates in total hip arthroplasty.   J Arthroplasty. 2014;29(11):2113-2116. doi:10.1016/j.arth.2014.07.019 PubMedGoogle ScholarCrossref
105.
Digas  G , Koutsogiannis  I , Meletiadis  G , Antonopoulou  E , Karamoulas  V , Bikos  CH .  Intra-articular injection of tranexamic acid reduce blood loss in cemented total knee arthroplasty.   Eur J Orthop Surg Traumatol. 2015;25(7):1181-1188. doi:10.1007/s00590-015-1664-8 PubMedGoogle ScholarCrossref
106.
Hsu  CH , Lin  PC , Kuo  FC , Wang  JW .  A regime of two intravenous injections of tranexamic acid reduces blood loss in minimally invasive total hip arthroplasty: a prospective randomised double-blind study.   Bone Joint J. 2015;97-B(7):905-910. doi:10.1302/0301-620X.97B7.35029 PubMedGoogle ScholarCrossref
107.
Jaszczyk  M , Kozerawski  D , Kołodziej  Ł , Kazimierczak  A , Sarnecki  P , Sieczka  Ł .  Effect of single preoperative dose of tranexamic acid on blood loss and transfusion in hip arthroplasty.   Ortop Traumatol Rehabil. 2015;17(3):265-273. doi:10.5604/15093492.1162426 PubMedGoogle ScholarCrossref
108.
Karaaslan  F , Karaoğlu  S , Yurdakul  E .  Reducing intra-articular hemarthrosis after arthroscopic anterior cruciate ligament reconstruction by the administration of intravenous tranexamic acid: a prospective, randomized controlled trial.   Am J Sports Med. 2015;43(11):2720-2726. doi:10.1177/0363546515599629 PubMedGoogle ScholarCrossref
109.
Kundu  R , Das  A , Basunia  SR , Bhattacharyya  T , Chattopadhyay  S , Mukherjee  A .  Does a single loading dose of tranexamic acid reduce perioperative blood loss and transfusion requirements after total knee replacement surgery? a randomized, controlled trial.   J Nat Sci Biol Med. 2015;6(1):94-99. doi:10.4103/0976-9668.149099 PubMedGoogle ScholarCrossref
110.
Lin  SY , Chen  CH , Fu  YC , Huang  PJ , Chang  JK , Huang  HT .  The efficacy of combined use of intraarticular and intravenous tranexamic acid on reducing blood loss and transfusion rate in total knee arthroplasty.   J Arthroplasty. 2015;30(5):776-780. doi:10.1016/j.arth.2014.12.001 PubMedGoogle ScholarCrossref
111.
Motififard  M , Tahririan  MA , Saneie  M , Badiei  S , Nemati  A .  Low dose perioperative intravenous tranexamic acid in patients undergoing total knee arthroplasty: a double-blind randomized placebo controlled clinical trial.   J Blood Transfus. 2015;2015:948304. doi:10.1155/2015/948304 PubMedGoogle Scholar
112.
Öztaş  S , Öztürk  A , Akalin  Y ,  et al.  The effect of local and systemic application of tranexamic acid on the amount of blood loss and allogeneic blood transfusion after total knee replacement.   Acta Orthop Belg. 2015;81(4):698-707.PubMedGoogle Scholar
113.
Peters  A , Verma  K , Slobodyanyuk  K ,  et al.  Antifibrinolytics reduce blood loss in adult spinal deformity surgery: a prospective, randomized controlled trial.   Spine (Phila Pa 1976). 2015;40(8):E443-E449. doi:10.1097/BRS.0000000000000799 PubMedGoogle ScholarCrossref
114.
Raksakietisak  M , Sathitkarnmanee  B , Srisaen  P ,  et al.  Two doses of tranexamic acid reduce blood transfusion in complex spine surgery: a prospective randomized study.   Spine (Phila Pa 1976). 2015;40(24):E1257-E1263. doi:10.1097/BRS.0000000000001063 PubMedGoogle ScholarCrossref
115.
Shen  PF , Hou  WL , Chen  JB , Wang  B , Qu  YX .  Effectiveness and safety of tranexamic acid for total knee arthroplasty: a prospective randomized controlled trial.   Med Sci Monit. 2015;21:576-581. doi:10.12659/MSM.892768 PubMedGoogle ScholarCrossref
116.
Shinde  A , Sobti  A , Maniar  S , Mishra  A , Gite  R , Shetty  V .  Tranexamic acid reduces blood loss and need of blood transfusion in total knee arthroplasty: a prospective, randomized, double-blind study in Indian population.   Asian J Transfus Sci. 2015;9(2):168-172. doi:10.4103/0973-6247.154251 PubMedGoogle ScholarCrossref
117.
Xie  B , Tian  J , Zhou  DP .  Administration of tranexamic acid reduces postoperative blood loss in calcaneal fractures: a randomized controlled trial.   J Foot Ankle Surg. 2015;54(6):1106-1110. doi:10.1053/j.jfas.2015.07.006PubMedGoogle ScholarCrossref
118.
Barrachina  B , Lopez-Picado  A , Remon  M ,  et al.  Tranexamic acid compared with placebo for reducing total blood loss in hip replacement surgery: a randomized clinical trial.   Anesth Analg. 2016;122(4):986-995. doi:10.1213/ANE.0000000000001159 PubMedGoogle ScholarCrossref
119.
Baruah  RK , Borah  PJ , Haque  R .  Use of tranexamic acid in dynamic hip screw plate fixation for trochanteric fractures.   J Orthop Surg (Hong Kong). 2016;24(3):379-382. doi:10.1177/1602400322 PubMedGoogle ScholarCrossref
120.
Chen  X , Cao  X , Yang  C , Guo  K , Zhu  Q , Zhu  J .  Effectiveness and safety of fixed-dose tranexamic acid in simultaneous bilateral total knee arthroplasty: a randomized double-blind controlled trial.  J Arthroplasty. 2016;31(11):2471-2475. doi:10.1016/j.arth.2016.04.003 PubMedGoogle ScholarCrossref
121.
Drosos  GI , Ververidis  A , Valkanis  C ,  et al.  A randomized comparative study of topical versus intravenous tranexamic acid administration in enhanced recovery after surgery (ERAS) total knee replacement.   J Orthop. 2016;13(3):127-131. doi:10.1016/j.jor.2016.03.007 PubMedGoogle ScholarCrossref
122.
Keyhani  S , Esmailiejah  AA , Abbasian  MR , Safdari  F .  Which route of tranexamic acid administration is more effective to reduce blood loss following total knee arthroplasty?   Arch Bone Jt Surg. 2016;4(1):65-69.PubMedGoogle Scholar
123.
Seviciu  A , Gross  I , Fathima  S , Walsh  SM .  Effects of tranexamic acid and bipolar sealer alone or in combination in primary total knee arthroplasty: a prospective, randomized, controlled trial.   Arthroplast Today. 2016;2(2):77-82. doi:10.1016/j.artd.2015.12.007 PubMedGoogle ScholarCrossref
124.
Tzatzairis  TK , Drosos  GI , Kotsios  SE , Ververidis  AN , Vogiatzaki  TD , Kazakos  KI .  Intravenous vs topical tranexamic acid in total knee arthroplasty without tourniquet application: a randomized controlled study.   J Arthroplasty. 2016;31(11):2465-2470. doi:10.1016/j.arth.2016.04.036 PubMedGoogle ScholarCrossref
125.
Volquind  D , Zardo  RA , Winkler  BC , Londero  BB , Zanelatto  N , Leichtweis  GP .  Use of tranexamic acid in primary total knee replacement: effects on perioperative blood loss.   Braz J Anesthesiol. 2016;66(3):254-258. doi:10.1016/j.bjan.2014.11.002 PubMedGoogle ScholarCrossref
126.
Wang  C , Kang  P , Ma  J , Yue  C , Xie  J , Pei  F .  Single-dose tranexamic acid for reducing bleeding and transfusions in total hip arthroplasty: a double-blind, randomized controlled trial of different doses.   Thromb Res. 2016;141:119-123. doi:10.1016/j.thromres.2016.02.027 PubMedGoogle ScholarCrossref
127.
Yi  Z , Bin  S , Jing  Y , Zongke  Z , Pengde  K , Fuxing  P .  Tranexamic acid administration in primary total hip arthroplasty: a randomized controlled trial of intravenous combined with topical versus single-dose intravenous administration.   J Bone Joint Surg Am. 2016;98(12):983-991. doi:10.2106/JBJS.15.00638 PubMedGoogle ScholarCrossref
128.
Zekcer  A , Del Priori  R , Tieppo  C , da Silva  RS , Severino  NR .  Topical vs intravenous administration of tranexamic acid in knee arthroplasty and prevalence of deep venous thrombosis: a randomized clinical trial.   J Vasc Bras. 2016;15(2):120-125. doi:10.1590/1677-5449.007515 PubMedGoogle ScholarCrossref
129.
Zhang  Y , Zhang  L , Ma  X ,  et al.  What is the optimal approach for tranexamic acid application in patients with unilateral total hip arthroplasty?   Orthopade. 2016;45(7):616-621. doi:10.1007/s00132-016-3252-y PubMedGoogle ScholarCrossref
130.
Fraval  A , Effeney  P , Fiddelaers  L , Smith  B , Towell  B , Tran  P .  OBTAIN A: Outcome Benefits of Tranexamic Acid in Hip Arthroplasty: a randomized double-blinded controlled trial.   J Arthroplasty. 2017;32(5):1516-1519. doi:10.1016/j.arth.2016.11.045 PubMedGoogle ScholarCrossref
131.
Huang  Z , Xie  X , Li  L ,  et al.  Intravenous and topical tranexamic acid alone are superior to tourniquet use for primary total knee arthroplasty: a prospective, randomized controlled trial.   J Bone Joint Surg Am. 2017;99(24):2053-2061. doi:10.2106/JBJS.16.01525 PubMedGoogle ScholarCrossref
132.
Lacko  M , Cellar  R , Schreierova  D , Vasko  G .  Comparison of intravenous and intra-articular tranexamic acid in reducing blood loss in primary total knee replacement.   Eklem Hastalik Cerrahisi. 2017;28(2):64-71. doi:10.5606/ehc.2017.54914 PubMedGoogle ScholarCrossref
133.
Melo  GLR , Lages  DS , Madureira Junior  JL , Pellucci  GP , Pellucci  JWJ .  The use of tranexamic acid in patients submitted to primary total hip arthroplasty: an evaluation of its impact in different administration protocols.   Rev Bras Ortop. 2017;52(suppl 1):34-39. doi:10.1016/j.rbo.2017.06.007 PubMedGoogle ScholarCrossref
134.
Prakash  J , Seon  JK , Park  YJ , Jin  C , Song  EK .  A randomized control trial to evaluate the effectiveness of intravenous, intra-articular and topical wash regimes of tranexamic acid in primary total knee arthroplasty.   J Orthop Surg (Hong Kong). 2017;25(1):2309499017693529. doi:10.1177/2309499017693529 PubMedGoogle Scholar
135.
Song  EK , Seon  JK , Prakash  J , Seol  YJ , Park  YJ , Jin  C .  Combined administration of intravenous and topical tranexamic acid is not superior to either individually in primary navigated TKA.   J Arthroplasty. 2017;32(1):37-42. doi:10.1016/j.arth.2016.06.052 PubMedGoogle ScholarCrossref
136.
Sun  Q , Yu  X , Nie  X , Gong  J , Cai  M .  The efficacy comparison of tranexamic acid for reducing blood loss in total knee arthroplasty at different dosage time.   J Arthroplasty. 2017;32(1):33-36. doi:10.1016/j.arth.2016.06.021 PubMedGoogle ScholarCrossref
137.
Sun  Q , Yu  X , Wu  J , Ge  W , Cai  M , Li  S .  Efficacy of a single dose and an additional dose of tranexamic acid in reduction of blood loss in total knee arthroplasty.   J Arthroplasty. 2017;32(7):2108-2112. doi:10.1016/j.arth.2016.10.003 PubMedGoogle ScholarCrossref
138.
Uğurlu  M , Aksekili  MA , Çağlar  C , Yüksel  K , Şahin  E , Akyol  M .  Effect of topical and intravenously applied tranexamic acid compared to control group on bleeding in primary unilateral total knee arthroplasty.   J Knee Surg. 2017;30(2):152-157. doi:10.1055/s-0036-1583270 PubMedGoogle ScholarCrossref
139.
Vara  AD , Koueiter  DM , Pinkas  DE , Gowda  A , Wiater  BP , Wiater  JM .  Intravenous tranexamic acid reduces total blood loss in reverse total shoulder arthroplasty: a prospective, double-blinded, randomized, controlled trial.   J Shoulder Elbow Surg. 2017;26(8):1383-1389. doi:10.1016/j.jse.2017.01.005 PubMedGoogle ScholarCrossref
140.
Wang  J , Wang  Q , Zhang  X , Wang  Q .  Intra-articular application is more effective than intravenous application of tranexamic acid in total knee arthroplasty: a prospective randomized controlled trial.   J Arthroplasty. 2017;32(11):3385-3389. doi:10.1016/j.arth.2017.06.024 PubMedGoogle ScholarCrossref
141.
Wang  JW , Chen  B , Lin  PC , Yen  SH , Huang  CC , Kuo  FC .  The efficacy of combined use of rivaroxaban and tranexamic acid on blood conservation in minimally invasive total knee arthroplasty: a double-blind randomized, controlled trial.   J Arthroplasty. 2017;32(3):801-806. doi:10.1016/j.arth.2016.08.020 PubMedGoogle ScholarCrossref
142.
Watts  CD , Houdek  MT , Sems  SA , Cross  WW , Pagnano  MW .  Tranexamic acid safely reduced blood loss in hemi- and total hip arthroplasty for acute femoral neck fracture: a randomized clinical trial.   J Orthop Trauma. 2017;31(7):345-351. doi:10.1097/BOT.0000000000000837 PubMedGoogle ScholarCrossref
143.
Yen  SH , Lin  PC , Chen  B , Huang  CC , Wang  JW .  Topical tranexamic acid reduces blood loss in minimally invasive total knee arthroplasty receiving rivaroxaban.   Biomed Res Int. 2017;2017:9105645. doi:10.1155/2017/9105645 PubMedGoogle Scholar
144.
Yuan  X , Li  B , Wang  Q , Zhang  X .  Comparison of 3 routes of administration of tranexamic acid on primary unilateral total knee arthroplasty: a prospective, randomized, controlled study.   J Arthroplasty. 2017;32(9):2738-2743. doi:10.1016/j.arth.2017.03.059 PubMedGoogle ScholarCrossref
145.
Zekcer  A , Priori  RD , Tieppo  C , Silva  RSD , Severino  NR .  Comparative study of topical vs intravenous tranexamic acid regarding blood loss in total knee arthroplasty.   Rev Bras Ortop. 2017;52(5):589-595. doi:10.1016/j.rbo.2016.09.012 PubMedGoogle ScholarCrossref
146.
Zeng  Y , Si  HB , Shen  B ,  et al.  Intravenous combined with topical administration of tranexamic acid in primary total hip arthroplasty: a randomized controlled trial.   Orthop Surg. 2017;9(2):174-179. doi:10.1111/os.12287 PubMedGoogle ScholarCrossref
147.
Liu  W , Yang  C , Huang  X , Liu  R .  Tranexamic acid reduces occult blood loss, blood transfusion, and improves recovery of knee function after total knee arthroplasty: a comparative study.   J Knee Surg. 2018;31(3):239-246. doi:10.1055/s-0037-1602248 PubMedGoogle ScholarCrossref
148.
López-Hualda  Á , Dauder-Gallego  C , Ferreño-Márquez  D , Martínez-Martín  J .  Efficacy and safety of topical tranexamic acid in knee arthroplasty.   Med Clin (Barc). 2018;151(11):431-434. doi:10.1016/j.medcle.2018.01.039PubMedGoogle ScholarCrossref
149.
Painter  TW , Daly  DJ , Kluger  R ,  et al.  Intravenous tranexamic acid and lower limb arthroplasty-a randomised controlled feasibility study.   Anaesth Intensive Care. 2018;46(4):386-395. doi:10.1177/0310057X1804600407 PubMedGoogle ScholarCrossref
150.
Zhao  H , Xiang  M , Xia  Y , Shi  X , Pei  FX , Kang  P .  Efficacy of oral tranexamic acid on blood loss in primary total hip arthroplasty using a direct anterior approach: a prospective randomized controlled trial.   Int Orthop. 2018;42(11):2535-2542. doi:10.1007/s00264-018-3846-6 PubMedGoogle ScholarCrossref
151.
Coffey  A , Pittmam  J , Halbrook  H , Fehrenbacher  J , Beckman  D , Hormuth  D .  The use of tranexamic acid to reduce postoperative bleeding following cardiac surgery: a double-blind randomized trial.   Am Surg. 1995;61(7):566-568.PubMedGoogle Scholar
152.
Horrow  JC , Van Riper  DF , Strong  MD , Grunewald  KE , Parmet  JL .  The dose-response relationship of tranexamic acid.   Anesthesiology. 1995;82(2):383-392. doi:10.1097/00000542-199502000-00009 PubMedGoogle ScholarCrossref
153.
Karski  JM , Teasdale  SJ , Norman  P ,  et al.  Prevention of bleeding after cardiopulmonary bypass with high-dose tranexamic acid: double-blind, randomized clinical trial.   J Thorac Cardiovasc Surg. 1995;110(3):835-842. doi:10.1016/S0022-5223(95)70118-4 PubMedGoogle ScholarCrossref
154.
Speekenbrink  RG , Vonk  AB , Wildevuur  CR , Eijsman  L .  Hemostatic efficacy of dipyridamole, tranexamic acid, and aprotinin in coronary bypass grafting.   Ann Thorac Surg. 1995;59(2):438-442. doi:10.1016/0003-4975(94)00865-5 PubMedGoogle ScholarCrossref
155.
Katsaros  D , Petricevic  M , Snow  NJ , Woodhall  DD , Van Bergen  R .  Tranexamic acid reduces postbypass blood use: a double-blinded, prospective, randomized study of 210 patients.   Ann Thorac Surg. 1996;61(4):1131-1135. doi:10.1016/0003-4975(96)00022-7 PubMedGoogle ScholarCrossref
156.
Shore-Lesserson  L , Reich  DL , Vela-Cantos  F , Ammar  T , Ergin  MA .  Tranexamic acid reduces transfusions and mediastinal drainage in repeat cardiac surgery.   Anesth Analg. 1996;83(1):18-26. doi:10.1213/00000539-199607000-00005 PubMedGoogle ScholarCrossref
157.
Brown  RS , Thwaites  BK , Mongan  PD .  Tranexamic acid is effective in decreasing postoperative bleeding and transfusions in primary coronary artery bypass operations: a double-blind, randomized, placebo-controlled trial.   Anesth Analg. 1997;85(5):963-970. doi:10.1213/00000539-199711000-00003 PubMedGoogle ScholarCrossref
158.
Dryden  PJ , O’Connor  JP , Jamieson  WR ,  et al.  Tranexamic acid reduces blood loss and transfusion in reoperative cardiac surgery.   Can J Anaesth. 1997;44(9):934-941. doi:10.1007/BF03011964 PubMedGoogle ScholarCrossref
159.
Hardy  JF , Bélisle  S , Dupont  C ,  et al.  Prophylactic tranexamic acid and epsilon-aminocaproic acid for primary myocardial revascularization.   Ann Thorac Surg. 1998;65(2):371-376. doi:10.1016/S0003-4975(97)01016-3 PubMedGoogle ScholarCrossref
160.
Nuttall  GA , Oliver  WC , Ereth  MH ,  et al.  Comparison of blood-conservation strategies in cardiac surgery patients at high risk for bleeding.   Anesthesiology. 2000;92(3):674-682. doi:10.1097/00000542-200003000-00010 PubMedGoogle ScholarCrossref
161.
Casati  V , Gerli  C , Franco  A ,  et al.  Tranexamic acid in off-pump coronary surgery: a preliminary, randomized, double-blind, placebo-controlled study.   Ann Thorac Surg. 2001;72(2):470-475. doi:10.1016/S0003-4975(01)02802-8 PubMedGoogle ScholarCrossref
162.
Zabeeda  D , Medalion  B , Sverdlov  M ,  et al.  Tranexamic acid reduces bleeding and the need for blood transfusion in primary myocardial revascularization.   Ann Thorac Surg. 2002;74(3):733-738. doi:10.1016/S0003-4975(02)03784-0 PubMedGoogle ScholarCrossref
163.
Pleym  H , Stenseth  R , Wahba  A , Bjella  L , Karevold  A , Dale  O .  Single-dose tranexamic acid reduces postoperative bleeding after coronary surgery in patients treated with aspirin until surgery.   Anesth Analg. 2003;96(4):923-928. doi:10.1213/01.ANE.0000054001.37346.03 PubMedGoogle ScholarCrossref
164.
Andreasen  JJ , Nielsen  C .  Prophylactic tranexamic acid in elective, primary coronary artery bypass surgery using cardiopulmonary bypass.   Eur J Cardiothorac Surg. 2004;26(2):311-317. doi:10.1016/j.ejcts.2004.03.012 PubMedGoogle ScholarCrossref
165.
Diprose  P , Herbertson  MJ , O’Shaughnessy  D , Deakin  CD , Gill  RS .  Reducing allogeneic transfusion in cardiac surgery: a randomized double-blind placebo-controlled trial of antifibrinolytic therapies used in addition to intra-operative cell salvage.   Br J Anaesth. 2005;94(3):271-278. doi:10.1093/bja/aei044 PubMedGoogle ScholarCrossref
166.
Karski  J , Djaiani  G , Carroll  J ,  et al.  Tranexamic acid and early saphenous vein graft patency in conventional coronary artery bypass graft surgery: a prospective randomized controlled clinical trial.   J Thorac Cardiovasc Surg. 2005;130(2):309-314. doi:10.1016/j.jtcvs.2004.11.015 PubMedGoogle ScholarCrossref
167.
Vanek  T , Jares  M , Fajt  R ,  et al.  Fibrinolytic inhibitors in off-pump coronary surgery: a prospective, randomized, double-blind TAP study (tranexamic acid, aprotinin, placebo).   Eur J Cardiothorac Surg. 2005;28(4):563-568. doi:10.1016/j.ejcts.2005.06.027 PubMedGoogle ScholarCrossref
168.
Murphy  GJ , Mango  E , Lucchetti  V ,  et al.  A randomized trial of tranexamic acid in combination with cell salvage plus a meta-analysis of randomized trials evaluating tranexamic acid in off-pump coronary artery bypass grafting.   J Thorac Cardiovasc Surg. 2006;132(3):475-480, 480.e1-480.e8. doi:10.1016/j.jtcvs.2006.01.064PubMedGoogle ScholarCrossref
169.
Santos  AT , Kalil  RA , Bauemann  C , Pereira  JB , Nesralla  IA .  A randomized, double-blind, and placebo-controlled study with tranexamic acid of bleeding and fibrinolytic activity after primary coronary artery bypass grafting.   Braz J Med Biol Res. 2006;39(1):63-69. doi:10.1590/S0100-879X2006000100007 PubMedGoogle ScholarCrossref
170.
Jimenez  JJ , Iribarren  JL , Lorente  L ,  et al.  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.   Crit Care. 2007;11(6):R117. doi:10.1186/cc6173 PubMedGoogle ScholarCrossref
171.
Chakravarthy  M , Muniraj  G , Patil  S , Suryaprakash  S , Mitra  S , Shivalingappa  B .  A randomized prospective analysis of alteration of hemostatic function in patients receiving tranexamic acid and hydroxyethyl starch (130/0.4) undergoing off pump coronary artery bypass surgery.   Ann Card Anaesth. 2012;15(2):105-110. doi:10.4103/0971-9784.95072 PubMedGoogle ScholarCrossref
172.
Myles  PS , Smith  JA , Forbes  A ,  et al; ATACAS Investigators of the ANZCA Clinical Trials Network.  Tranexamic acid in patients undergoing coronary-artery surgery.   N Engl J Med. 2017;376(2):136-148. doi:10.1056/NEJMoa1606424 PubMedGoogle ScholarCrossref
173.
Chandra  B .  Treatment of subarachnoid hemorrhage from ruptured intracranial aneurysm with tranexamic acid: a double-blind clinical trial.   Ann Neurol. 1978;3(6):502-504. doi:10.1002/ana.410030607 PubMedGoogle ScholarCrossref
174.
Fodstad  H , Liliequist  B , Schannong  M , Thulin  CA .  Tranexamic acid in the preoperative management of ruptured intracranial aneurysms.   Surg Neurol. 1978;10(1):9-15.PubMedGoogle Scholar
175.
Maurice-Williams  RS .  Prolonged antifibrinolysis: an effective non-surgical treatment for ruptured intracranial aneurysms?   BMJ. 1978;1(6118):945-947. doi:10.1136/bmj.1.6118.945 PubMedGoogle ScholarCrossref
176.
Kaste  M , Ramsay  M .  Tranexamic acid in subarachnoid hemorrhage: a double-blind study.   Stroke. 1979;10(5):519-522. doi:10.1161/01.STR.10.5.519 PubMedGoogle ScholarCrossref
177.
Fodstad  H , Forssell  A , Liliequist  B , Schannong  M .  Antifibrinolysis with tranexamic acid in aneurysmal subarachnoid hemorrhage: a consecutive controlled clinical trial.   Neurosurgery. 1981;8(2):158-165. doi:10.1227/00006123-198102000-00004 PubMedGoogle ScholarCrossref
178.
Vermeulen  M , Lindsay  KW , Murray  GD ,  et al.  Antifibrinolytic treatment in subarachnoid hemorrhage.   N Engl J Med. 1984;311(7):432-437. doi:10.1056/NEJM198408163110703 PubMedGoogle ScholarCrossref
179.
Tsementzis  SA , Hitchcock  ER , Meyer  CH .  Benefits and risks of antifibrinolytic therapy in the management of ruptured intracranial aneurysms: a double-blind placebo-controlled study.   Acta Neurochir (Wien). 1990;102(1-2):1-10. doi:10.1007/BF01402177 PubMedGoogle ScholarCrossref
180.
Roos  Y ; STAR Study Group.  Antifibrinolytic treatment in subarachnoid hemorrhage: a randomized placebo-controlled trial.   Neurology. 2000;54(1):77-82. doi:10.1212/WNL.54.1.77 PubMedGoogle ScholarCrossref
181.
Hillman  J , Fridriksson  S , Nilsson  O , Yu  Z , Saveland  H , Jakobsson  KE .  Immediate administration of tranexamic acid and reduced incidence of early rebleeding after aneurysmal subarachnoid hemorrhage: a prospective randomized study.   J Neurosurg. 2002;97(4):771-778. doi:10.3171/jns.2002.97.4.0771 PubMedGoogle ScholarCrossref
182.
Yutthakasemsunt  S , Kittiwatanagul  W , Piyavechvirat  P , Thinkamrop  B , Phuenpathom  N , Lumbiganon  P .  Tranexamic acid for patients with traumatic brain injury: a randomized, double-blinded, placebo-controlled trial.   BMC Emerg Med. 2013;13:20. doi:10.1186/1471-227X-13-20 PubMedGoogle ScholarCrossref
183.
Sprigg  N , Renton  CJ , Dineen  RA , Kwong  Y , Bath  PM .  Tranexamic acid for spontaneous intracerebral hemorrhage: a randomized controlled pilot trial (ISRCTN50867461).   J Stroke Cerebrovasc Dis. 2014;23(6):1312-1318. doi:10.1016/j.jstrokecerebrovasdis.2013.11.007 PubMedGoogle ScholarCrossref
184.
Arumugam  A , A Rahman  NA , Theophilus  SC , Shariffudin  A , Abdullah  JM .  Tranexamic acid as antifibrinolytic agent in non traumatic intracerebral hemorrhages.   Malays J Med Sci. 2015;22(Spec Issue):62-71.PubMedGoogle Scholar
185.
Vel  R , Udupi  BP , Satya Prakash  MV , Adinarayanan  S , Mishra  S , Babu  L .  Effect of low dose tranexamic acid on intra-operative blood loss in neurosurgical patients.   Saudi J Anaesth. 2015;9(1):42-48. doi:10.4103/1658-354X.146304 PubMedGoogle ScholarCrossref
186.
Hooda  B , Chouhan  RS , Rath  GP , Bithal  PK , Suri  A , Lamsal  R .  Effect of tranexamic acid on intraoperative blood loss and transfusion requirements in patients undergoing excision of intracranial meningioma.   J Clin Neurosci. 2017;41:132-138. doi:10.1016/j.jocn.2017.02.053 PubMedGoogle ScholarCrossref
187.
Zonis  Z , Seear  M , Reichert  C , Sett  S , Allen  C .  The effect of preoperative tranexamic acid on blood loss after cardiac operations in children.   J Thorac Cardiovasc Surg. 1996;111(5):982-987. doi:10.1016/S0022-5223(96)70374-4 PubMedGoogle ScholarCrossref
188.
Dadure  C , Sauter  M , Bringuier  S ,  et al.  Intraoperative tranexamic acid reduces blood transfusion in children undergoing craniosynostosis surgery: a randomized double-blind study.   Anesthesiology. 2011;114(4):856-861. doi:10.1097/ALN.0b013e318210f9e3 PubMedGoogle ScholarCrossref
189.
Goobie  SM , Meier  PM , Pereira  LM ,  et al.  Efficacy of tranexamic acid in pediatric craniosynostosis surgery: a double-blind, placebo-controlled trial.   Anesthesiology. 2011;114(4):862-871. doi:10.1097/ALN.0b013e318210fd8f PubMedGoogle ScholarCrossref
190.
Biggs  JC , Hugh  TB , Dodds  AJ .  Tranexamic acid and upper gastrointestinal haemorrhage–a double-blind trial.   Gut. 1976;17(9):729-734. doi:10.1136/gut.17.9.729 PubMedGoogle ScholarCrossref
191.
Engqvist  A , Broström  O , von Feilitzen  F ,  et al.  Tranexamic acid in massive haemorrhage from the upper gastrointestinal tract: a double-blind study.   Scand J Gastroenterol. 1979;14(7):839-844. doi:10.3109/00365527909181413 PubMedGoogle ScholarCrossref
192.
Barer  D , Ogilvie  A , Henry  D ,  et al.  Cimetidine and tranexamic acid in the treatment of acute upper-gastrointestinal-tract bleeding.   N Engl J Med. 1983;308(26):1571-1575. doi:10.1056/NEJM198306303082606 PubMedGoogle ScholarCrossref
193.
Auvinen  O , Baer  GA , Nordback  I , Saaristo  J .  Antifibrinolytic therapy for prevention of hemorrhage during surgery of the thyroid gland.   Klin Wochenschr. 1987;65(6):253-255. doi:10.1007/BF01773442 PubMedGoogle ScholarCrossref
194.
von Holstein  CC , Eriksson  SB , Källén  R .  Tranexamic acid as an aid to reducing blood transfusion requirements in gastric and duodenal bleeding.   BMJ (Clin Res Ed). 1987;294(6563):7-10. doi:10.1136/bmj.294.6563.7 PubMedGoogle ScholarCrossref
195.
Yassen  K , Bellamy  MC , Sadek  SA , Webster  NR .  Tranexamic acid reduces blood loss during orthotopic liver transplantation.   Clin Transplant. 1993;7(5):453-458.Google Scholar
196.
Boylan  JF , Klinck  JR , Sandler  AN ,  et al.  Tranexamic acid reduces blood loss, transfusion requirements, and coagulation factor use in primary orthotopic liver transplantation.   Anesthesiology. 1996;85(5):1043-1048. doi:10.1097/00000542-199611000-00012 PubMedGoogle ScholarCrossref
197.
Kaspar  M , Ramsay  MA , Nguyen  AT , Cogswell  M , Hurst  G , Ramsay  KJ .  Continuous small-dose tranexamic acid reduces fibrinolysis but not transfusion requirements during orthotopic liver transplantation.   Anesth Analg. 1997;85(2):281-285. doi:10.1097/00000539-199708000-00007PubMedGoogle Scholar
198.
Dalmau  A , Sabaté  A , Acosta  F ,  et al.  Comparative study of antifibrinolytic drugs in orthotopic liver transplantation.   Transplant Proc. 1999;31(6):2361-2362. doi:10.1016/S0041-1345(99)00378-4 PubMedGoogle ScholarCrossref
199.
Ramezani  AR , Ahmadieh  H , Ghaseminejad  AK , Yazdani  S , Golestan  B .  Effect of tranexamic acid on early postvitrectomy diabetic haemorrhage; a randomised clinical trial.   Br J Ophthalmol. 2005;89(8):1041-1044. doi:10.1136/bjo.2004.062638 PubMedGoogle ScholarCrossref
200.
Wu  CC , Ho  WM , Cheng  SB ,  et al.  Perioperative parenteral tranexamic acid in liver tumor resection: a prospective randomized trial toward a “blood transfusion”-free hepatectomy.   Ann Surg. 2006;243(2):173-180. doi:10.1097/01.sla.0000197561.70972.73 PubMedGoogle ScholarCrossref
201.
Crescenti  A , Borghi  G , Bignami  E ,  et al.  Intraoperative use of tranexamic acid to reduce transfusion rate in patients undergoing radical retropubic prostatectomy: double blind, randomised, placebo controlled trial.   BMJ. 2011;343:d5701. doi:10.1136/bmj.d5701 PubMedGoogle ScholarCrossref
202.
Kumsar  S , Dirim  A , Toksöz  S , Sağlam  HS , Adsan  O .  Tranexamic acid decreases blood loss during transurethral resection of the prostate (TUR -P).   Cent European J Urol. 2011;64(3):156-158. doi:10.5173/ceju.2011.03.art13 PubMedGoogle ScholarCrossref
203.
Jendoubi  A , Malouch  A , Bouzouita  A ,  et al.  Safety and efficacy of intravenous tranexamic acid in endoscopic transurethral resections in urology: prospective randomized trial.  Article in French.  Prog Urol. 2017;27(16):1036-1042. doi:10.1016/j.purol.2017.09.008 PubMedGoogle ScholarCrossref
204.
Mohammadi-Sichani  M , Kazemi  R , Nouri-Mahdavi  K , Gholipour  F .  Reevaluation of the efficacy of tranexamic acid in reducing blood loss in percutaneous nephrolithotomy: a randomized clinical trial.   Minerva Urol Nefrol. 2019;71(1):55-62. doi:10.23736/S0393-2249.18.03151-XPubMedGoogle ScholarCrossref
205.
Tavakoli  N , Mokhtare  M , Agah  S ,  et al.  Comparison of the efficacy of intravenous tranexamic acid with and without topical administration versus placebo in urgent endoscopy rate for acute gastrointestinal bleeding: a double-blind randomized controlled trial.   United European Gastroenterol J. 2018;6(1):46-54. doi:10.1177/2050640617714940 PubMedGoogle ScholarCrossref
206.
CRASH-3 Trial Collaborators.  Effects of tranexamic acid on death, disability, vascular occlusive events and other morbidities in patients with acute traumatic brain injury (CRASH-3): a randomised, placebo-controlled trial.   Lancet. 2019;394(10210):1713-1723. doi:10.1016/S0140-6736(19)32233-0 PubMedGoogle ScholarCrossref
207.
HALT-IT Trial Collaborators.  Effects of a high-dose 24-h infusion of tranexamic acid on death and thromboembolic events in patients with acute gastrointestinal bleeding (HALT-IT): an international randomised, double-blind, placebo-controlled trial.   Lancet. 2020;395(10241):1927-1936. doi:10.1016/S0140-6736(20)30848-5 PubMedGoogle ScholarCrossref
208.
Abdul  IF , Amadu  MB , Adesina  KT , Olarinoye  AO , Omokanye  LO .  Adjunctive use of tranexamic acid to tourniquet in reducing haemorrhage during abdominal myomectomy: a randomized controlled trial.   Eur J Obstet Gynecol Reprod Biol. 2019;242:150-158. doi:10.1016/j.ejogrb.2019.09.010 PubMedGoogle ScholarCrossref
209.
Batıbay  SG , Türkmen  İ , Duman  S , Çamur  S , Sağlam  N , Batıbay  S .  Is tranexamic acid safe and reliable during tibial intramedullary nailing?   Ulus Travma Acil Cerrahi Derg. 2018;24(6):575-580. doi:10.5505/tjtes.2018.42147PubMedGoogle Scholar
210.
Chen  F , Jiang  Z , Li  M , Zhu  X .  Efficacy and safety of perioperative tranexamic acid in elderly patients undergoing trochanteric fracture surgery: a randomised controlled trial.   Hong Kong Med J. 2019;25(2):120-126. doi:10.12809/hkmj187570PubMedGoogle Scholar
211.
Clavé  A , Gérard  R , Lacroix  J ,  et al.  A randomized, double-blind, placebo-controlled trial on the efficacy of tranexamic acid combined with rivaroxaban thromboprophylaxis in reducing blood loss after primary cementless total hip arthroplasty.   Bone Joint J. 2019;101-B(2):207-212. doi:10.1302/0301-620X.101B2.BJJ-2018-0898.R1PubMedGoogle ScholarCrossref
212.
Cuff  DJ , Simon  P , Gorman  RA  II .  Randomized prospective evaluation of the use of tranexamic acid and effects on blood loss for proximal humeral fracture surgery.   J Shoulder Elbow Surg. 2020;29(8):1627-1632. doi:10.1016/j.jse.2020.04.016 PubMedGoogle ScholarCrossref
213.
Felli  L , Revello  S , Burastero  G ,  et al.  Single intravenous administration of tranexamic acid in anterior cruciate ligament reconstruction to reduce postoperative hemarthrosis and increase functional outcomes in the early phase of postoperative rehabilitation: a randomized controlled trial.   Arthroscopy. 2019;35(1):149-157. doi:10.1016/j.arthro.2018.07.050PubMedGoogle ScholarCrossref
214.
Fenger-Eriksen  C , D’Amore Lindholm  A , Nørholt  SE ,  et al.  Reduced perioperative blood loss in children undergoing craniosynostosis surgery using prolonged tranexamic acid infusion: a randomised trial.   Br J Anaesth. 2019;122(6):760-766. doi:10.1016/j.bja.2019.02.017 PubMedGoogle ScholarCrossref
215.
Karampinas  PK , Megaloikonomos  PD , Lampropoulou-Adamidou  K ,  et al.  Similar thromboprophylaxis with rivaroxaban and low molecular weight heparin but fewer hemorrhagic complications with combined intra-articular and intravenous tranexamic acid in total knee arthroplasty.   Eur J Orthop Surg Traumatol. 2019;29(2):455-460. doi:10.1007/s00590-018-2307-7 PubMedGoogle ScholarCrossref
216.
Lei  Y , Xie  J , Huang  Q , Huang  W , Pei  F .  Additional benefits of multiple-dose tranexamic acid to anti-fibrinolysis and anti-inflammation in total knee arthroplasty: a randomized controlled trial.   Arch Orthop Trauma Surg. 2020;140(8):1087-1095. doi:10.1007/s00402-020-03442-2 PubMedGoogle ScholarCrossref
217.
Levack  AE , McLawhorn  AS , Dodwell  E , DelPizzo  K , Nguyen  J , Sink  E .  Intravenous tranexamic acid reduces blood loss and transfusion requirements after periacetabular osteotomy.   Bone Joint J. 2020;102-B(9):1151-1157. doi:10.1302/0301-620X.102B9.BJJ-2019-1777.R1PubMedGoogle ScholarCrossref
218.
Liu  YF , Hong  CK , Hsu  KL ,  et al.  Intravenous administration of tranexamic acid significantly improved clarity of the visual field in arthroscopic shoulder surgery: a prospective, double-blind, and randomized controlled trial.   Arthroscopy. 2020;36(3):640-647. doi:10.1016/j.arthro.2019.10.020PubMedGoogle ScholarCrossref
219.
Meretoja  A , Yassi  N , Wu  TY ,  et al.  Tranexamic Acid in Patients With Intracerebral Haemorrhage (STOP-AUST): a multicentre, randomised, placebo-controlled, phase 2 trial.   Lancet Neurol. 2020;19(12):980-987. doi:10.1016/S1474-4422(20)30369-0 PubMedGoogle ScholarCrossref
220.
Monaco  F , Nardelli  P , Pasin  L ,  et al.  Tranexamic acid in open aortic aneurysm surgery: a randomised clinical trial.   Br J Anaesth. 2020;124(1):35-43. doi:10.1016/j.bja.2019.08.028 PubMedGoogle ScholarCrossref
221.
Mu  X , Wei  J , Wang  C ,  et al.  Intravenous administration of tranexamic acid significantly reduces visible and hidden blood loss compared with its topical administration for double-segment posterior lumbar interbody fusion: a single-center, placebo-controlled, randomized trial.   World Neurosurg. 2019;122:e821-e827. doi:10.1016/j.wneu.2018.10.154 PubMedGoogle ScholarCrossref
222.
Opoku-Anane  J , Vargas  MV , Marfori  CQ , Moawad  G , Maasen  MS , Robinson  JK .  Intraoperative tranexamic acid to decrease blood loss during myomectomy: a randomized, double-blind, placebo-controlled trial.   Am J Obstet Gynecol. 2020;223(3):413.e1-413.e7. doi:10.1016/j.ajog.2020.02.019 PubMedGoogle ScholarCrossref
223.
Rowell  SE , Meier  EN , McKnight  B ,  et al.  Effect of out-of-hospital tranexamic acid vs placebo on 6-month functional neurologic outcomes in patients with moderate or severe traumatic brain injury.   JAMA. 2020;324(10):961-974. doi:10.1001/jama.2020.8958 PubMedGoogle ScholarCrossref
224.
Sentilhes  L , Winer  N , Azria  E ,  et al; Groupe de Recherche en Obstétrique et Gynécologie.  Tranexamic acid for the prevention of blood loss after vaginal delivery.   N Engl J Med. 2018;379(8):731-742. doi:10.1056/NEJMoa1800942 PubMedGoogle ScholarCrossref
225.
Sidelmann  JJ , Gram  JB , Godtfredsen  ACM , Thorn  JJ , Ingerslev  J ; Pinholt  EM .  Orthognathic surgery-induced fibrinolytic shutdown is amplified by tranexamic acid.   J Oral Maxillofac Surg. 2020;78(7):1183-1189. doi:10.1016/j.joms.2020.02.026 PubMedGoogle ScholarCrossref
226.
Xu  X , Jiang  J , Liu  W , Li  X , Lu  H .  Application of thromboelastography to evaluate the effect of different routes administration of tranexamic acid on coagulation function in total hip arthroplasty.   J Orthop Surg Res. 2019;14(1):430. doi:10.1186/s13018-019-1497-y PubMedGoogle ScholarCrossref
227.
Zaman  SU , Zakir  I , Faraz  Q , Akhtar  S , Nawaz  A , Adeel  M .  Effect of single-dose intravenous tranexamic acid on postoperative nasal bleed in septoplasty.   Eur Ann Otorhinolaryngol Head Neck Dis. 2019;136(6):435-438. doi:10.1016/j.anorl.2018.10.019 PubMedGoogle ScholarCrossref
228.
Zhou  KD , Wang  HY , Wang  Y , Liu  ZH , He  C , Feng  JM .  Is topical or intravenous tranexamic acid preferred in total hip arthroplasty? a randomized, controlled, noninferiority clinical trial.   PLoS One. 2018;13(10):e0204551. doi:10.1371/journal.pone.0204551 PubMedGoogle Scholar
229.
Zhou  XD , Zhang  Y , Jiang  LF ,  et al.  Efficacy and safety of tranexamic acid in intertrochanteric fractures: a single-blind randomized controlled trial.   Orthop Surg. 2019;11(4):635-642. doi:10.1111/os.12511 PubMedGoogle ScholarCrossref
230.
World Health Organization. 18th Expert Committee on the Selection and Use of Essential Medicines. Published 2011. Accessed March 8, 2021. https://www.who.int/selection_medicines/committees/expert/18/en/
231.
Yates  J , Perelman  I , Khair  S ,  et al.  Exclusion criteria and adverse events in perioperative trials of tranexamic acid: a systematic review and meta-analysis.   Transfusion. 2019;59(2):806-824. doi:10.1111/trf.15030 PubMedGoogle ScholarCrossref
232.
Franchini  M , Mengoli  C , Cruciani  M ,  et al.  Safety and efficacy of tranexamic acid for prevention of obstetric haemorrhage: an updated systematic review and meta-analysis.   Blood Transfus. 2018;16(4):329-337. doi:10.2450/2018.0026-18PubMedGoogle Scholar
233.
Eriksson  O , Kjellman  H , Pilbrant  A , Schannong  M .  Pharmacokinetics of tranexamic acid after intravenous administration to normal volunteers.   Eur J Clin Pharmacol. 1974;7(5):375-380. doi:10.1007/BF00558210 PubMedGoogle ScholarCrossref
234.
Pilbrant  A , Schannong  M , Vessman  J .  Pharmacokinetics and bioavailability of tranexamic acid.   Eur J Clin Pharmacol. 1981;20(1):65-72. doi:10.1007/BF00554669 PubMedGoogle ScholarCrossref
235.
Schiff  RL , Kahn  SR , Shrier  I ,  et al.  Identifying orthopedic patients at high risk for venous thromboembolism despite thromboprophylaxis.   Chest. 2005;128(5):3364-3371. doi:10.1378/chest.128.5.3364 PubMedGoogle ScholarCrossref
236.
Encke  A , Haas  S , Kopp  I .  The prophylaxis of venous thromboembolism.   Dtsch Arztebl Int. 2016;113(31-32):532-538. doi:10.3238/arztebl.2016.0532PubMedGoogle Scholar
If you are not a JN Learning subscriber, you can either:
Subscribe to JN Learning for one year
Buy this activity
jn-learning_Modal_Multimedia_LoginSubscribe_Purchase
Close
If you are not a JN Learning subscriber, you can either:
Subscribe to JN Learning for one year
Buy this activity
jn-learning_Modal_Multimedia_LoginSubscribe_Purchase
Close
With a personal account, you can:
  • Access free activities and track your credits
  • Personalize content alerts
  • Customize your interests
  • Fully personalize your learning experience
Education Center Collection Sign In Modal Right
Close

Name Your Search

Save Search
Close
With a personal account, you can:
  • Track your credits
  • Personalize content alerts
  • Customize your interests
  • Fully personalize your learning experience
jn-learning_Modal_SaveSearch_NoAccess_Purchase
Close

Lookup An Activity

or

Close

My Saved Searches

You currently have no searches saved.

Close
With a personal account, you can:
  • Access free activities and track your credits
  • Personalize content alerts
  • Customize your interests
  • Fully personalize your learning experience
Education Center Collection Sign In Modal Right
Close