Comparative analysis of tranexamic acid use in minimally invasive versus open craniosynostosis procedures

Todd A. Maugans, David Martin, Jesse Taylor, Shelia Salisbury, George Istaphanous

Research output: Contribution to journalArticle

Abstract

BACKGROUND: Intraoperatively administered tranexamic acid (TXA) lessens blood loss during orthopedic and cardiovascular surgery. Its use for craniosynostosis surgery warrants investigation. Therefore, we analyzed our use of TXA during minimally invasive (MI) and open craniosynostosis procedures. METHODS: Fifty-six patients were retrospectively studied: 20 in the MI group, 10 receiving TXA; 36 in the open group, 16 receiving TXA. Study variables were weight-adjusted estimated blood loss (EBL) and calculated blood loss (CBL), transfusion and incidence, transfusion volume, and complications. Calculated blood loss was determined by a novel formula based on red cell mass. RESULTS: In the MI group, median EBL was significantly lower for TXA recipients (9.62 vs 15.94 mL/kg, P = 0.0231), whereas median CBL was not (36.59 vs 34.12 mL/kg, P = 0.7976). Transfusion incidences were 80% TXA versus 100% control (P = 0.4737). Median transfusion volume trended lower (10.76 vs 19.43 mL/kg, P = 0.0723).In the open group, median EBL and CBL for TXA recipients were lower but not significantly different than for nonrecipients (21.86 vs 23.40 mL/kg, P = 0.7416; 53.54 vs 80.13; P = 0.3137). All patients had a transfusion. Median transfusion volume for TXA recipients versus nonrecipients was 34.01 versus 40.35 mL/kg (P = 0.3137). Tranexamic acid greatly minimized the range of EBL and CBL in both surgical groups. There was a significant correlation between the CBL and EBL (P < 0.0001). There were no adverse events. CONCLUSIONS: Intraoperative TXA administration is safe with modest benefit suggested, especially in the MI group. Calculated blood loss correlated well with EBL at lower blood loss volumes, implicating it as a potential measurement of true blood loss.

Original languageEnglish (US)
Pages (from-to)1772-1778
Number of pages7
JournalJournal of Craniofacial Surgery
Volume22
Issue number5
DOIs
StatePublished - Sep 1 2011
Externally publishedYes

Fingerprint

Tranexamic Acid
Craniosynostoses
Erythrocyte Volume
Incidence
Blood Volume
Blood Transfusion

Keywords

  • Blood loss
  • Craniosynostosis
  • Tranexamic acid

ASJC Scopus subject areas

  • Surgery
  • Otorhinolaryngology

Cite this

Comparative analysis of tranexamic acid use in minimally invasive versus open craniosynostosis procedures. / Maugans, Todd A.; Martin, David; Taylor, Jesse; Salisbury, Shelia; Istaphanous, George.

In: Journal of Craniofacial Surgery, Vol. 22, No. 5, 01.09.2011, p. 1772-1778.

Research output: Contribution to journalArticle

Maugans, Todd A. ; Martin, David ; Taylor, Jesse ; Salisbury, Shelia ; Istaphanous, George. / Comparative analysis of tranexamic acid use in minimally invasive versus open craniosynostosis procedures. In: Journal of Craniofacial Surgery. 2011 ; Vol. 22, No. 5. pp. 1772-1778.
@article{fe90576e6cb5485c9183882a75c20e56,
title = "Comparative analysis of tranexamic acid use in minimally invasive versus open craniosynostosis procedures",
abstract = "BACKGROUND: Intraoperatively administered tranexamic acid (TXA) lessens blood loss during orthopedic and cardiovascular surgery. Its use for craniosynostosis surgery warrants investigation. Therefore, we analyzed our use of TXA during minimally invasive (MI) and open craniosynostosis procedures. METHODS: Fifty-six patients were retrospectively studied: 20 in the MI group, 10 receiving TXA; 36 in the open group, 16 receiving TXA. Study variables were weight-adjusted estimated blood loss (EBL) and calculated blood loss (CBL), transfusion and incidence, transfusion volume, and complications. Calculated blood loss was determined by a novel formula based on red cell mass. RESULTS: In the MI group, median EBL was significantly lower for TXA recipients (9.62 vs 15.94 mL/kg, P = 0.0231), whereas median CBL was not (36.59 vs 34.12 mL/kg, P = 0.7976). Transfusion incidences were 80{\%} TXA versus 100{\%} control (P = 0.4737). Median transfusion volume trended lower (10.76 vs 19.43 mL/kg, P = 0.0723).In the open group, median EBL and CBL for TXA recipients were lower but not significantly different than for nonrecipients (21.86 vs 23.40 mL/kg, P = 0.7416; 53.54 vs 80.13; P = 0.3137). All patients had a transfusion. Median transfusion volume for TXA recipients versus nonrecipients was 34.01 versus 40.35 mL/kg (P = 0.3137). Tranexamic acid greatly minimized the range of EBL and CBL in both surgical groups. There was a significant correlation between the CBL and EBL (P < 0.0001). There were no adverse events. CONCLUSIONS: Intraoperative TXA administration is safe with modest benefit suggested, especially in the MI group. Calculated blood loss correlated well with EBL at lower blood loss volumes, implicating it as a potential measurement of true blood loss.",
keywords = "Blood loss, Craniosynostosis, Tranexamic acid",
author = "Maugans, {Todd A.} and David Martin and Jesse Taylor and Shelia Salisbury and George Istaphanous",
year = "2011",
month = "9",
day = "1",
doi = "10.1097/SCS.0b013e31822e6283",
language = "English (US)",
volume = "22",
pages = "1772--1778",
journal = "Journal of Craniofacial Surgery",
issn = "1049-2275",
publisher = "Lippincott Williams and Wilkins",
number = "5",

}

TY - JOUR

T1 - Comparative analysis of tranexamic acid use in minimally invasive versus open craniosynostosis procedures

AU - Maugans, Todd A.

AU - Martin, David

AU - Taylor, Jesse

AU - Salisbury, Shelia

AU - Istaphanous, George

PY - 2011/9/1

Y1 - 2011/9/1

N2 - BACKGROUND: Intraoperatively administered tranexamic acid (TXA) lessens blood loss during orthopedic and cardiovascular surgery. Its use for craniosynostosis surgery warrants investigation. Therefore, we analyzed our use of TXA during minimally invasive (MI) and open craniosynostosis procedures. METHODS: Fifty-six patients were retrospectively studied: 20 in the MI group, 10 receiving TXA; 36 in the open group, 16 receiving TXA. Study variables were weight-adjusted estimated blood loss (EBL) and calculated blood loss (CBL), transfusion and incidence, transfusion volume, and complications. Calculated blood loss was determined by a novel formula based on red cell mass. RESULTS: In the MI group, median EBL was significantly lower for TXA recipients (9.62 vs 15.94 mL/kg, P = 0.0231), whereas median CBL was not (36.59 vs 34.12 mL/kg, P = 0.7976). Transfusion incidences were 80% TXA versus 100% control (P = 0.4737). Median transfusion volume trended lower (10.76 vs 19.43 mL/kg, P = 0.0723).In the open group, median EBL and CBL for TXA recipients were lower but not significantly different than for nonrecipients (21.86 vs 23.40 mL/kg, P = 0.7416; 53.54 vs 80.13; P = 0.3137). All patients had a transfusion. Median transfusion volume for TXA recipients versus nonrecipients was 34.01 versus 40.35 mL/kg (P = 0.3137). Tranexamic acid greatly minimized the range of EBL and CBL in both surgical groups. There was a significant correlation between the CBL and EBL (P < 0.0001). There were no adverse events. CONCLUSIONS: Intraoperative TXA administration is safe with modest benefit suggested, especially in the MI group. Calculated blood loss correlated well with EBL at lower blood loss volumes, implicating it as a potential measurement of true blood loss.

AB - BACKGROUND: Intraoperatively administered tranexamic acid (TXA) lessens blood loss during orthopedic and cardiovascular surgery. Its use for craniosynostosis surgery warrants investigation. Therefore, we analyzed our use of TXA during minimally invasive (MI) and open craniosynostosis procedures. METHODS: Fifty-six patients were retrospectively studied: 20 in the MI group, 10 receiving TXA; 36 in the open group, 16 receiving TXA. Study variables were weight-adjusted estimated blood loss (EBL) and calculated blood loss (CBL), transfusion and incidence, transfusion volume, and complications. Calculated blood loss was determined by a novel formula based on red cell mass. RESULTS: In the MI group, median EBL was significantly lower for TXA recipients (9.62 vs 15.94 mL/kg, P = 0.0231), whereas median CBL was not (36.59 vs 34.12 mL/kg, P = 0.7976). Transfusion incidences were 80% TXA versus 100% control (P = 0.4737). Median transfusion volume trended lower (10.76 vs 19.43 mL/kg, P = 0.0723).In the open group, median EBL and CBL for TXA recipients were lower but not significantly different than for nonrecipients (21.86 vs 23.40 mL/kg, P = 0.7416; 53.54 vs 80.13; P = 0.3137). All patients had a transfusion. Median transfusion volume for TXA recipients versus nonrecipients was 34.01 versus 40.35 mL/kg (P = 0.3137). Tranexamic acid greatly minimized the range of EBL and CBL in both surgical groups. There was a significant correlation between the CBL and EBL (P < 0.0001). There were no adverse events. CONCLUSIONS: Intraoperative TXA administration is safe with modest benefit suggested, especially in the MI group. Calculated blood loss correlated well with EBL at lower blood loss volumes, implicating it as a potential measurement of true blood loss.

KW - Blood loss

KW - Craniosynostosis

KW - Tranexamic acid

UR - http://www.scopus.com/inward/record.url?scp=80053525300&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=80053525300&partnerID=8YFLogxK

U2 - 10.1097/SCS.0b013e31822e6283

DO - 10.1097/SCS.0b013e31822e6283

M3 - Article

C2 - 21959429

AN - SCOPUS:80053525300

VL - 22

SP - 1772

EP - 1778

JO - Journal of Craniofacial Surgery

JF - Journal of Craniofacial Surgery

SN - 1049-2275

IS - 5

ER -