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Tranexamic Acid Utilization in Craniosynostosis Surgery
Ebru Atike Ongun1, Oguz Dursun, Mehmet Saim Kazan
1Akdeniz University Faculty of Medicine, Department of Pediatrics, Division of Pediatric Critical Care, Antalya, Turkey.
Turkish Neurosurgery
|February 6, 2020
Summary
Tranexamic acid (TXA) reduces intraoperative blood loss and transfusion needs in craniosynostosis surgery. However, it does not significantly impact postoperative hemodynamics, highlighting the importance of managing bleeding risks throughout the perioperative period.
Area of Science:
- Pediatric Surgery
- Anesthesiology
- Hematology
Background:
- Craniosynostosis surgery involves significant blood loss.
- Hemodynamic stability is critical during the perioperative period in pediatric patients.
- Tranexamic acid (TXA) is used to reduce bleeding in various surgical settings.
Purpose of the Study:
- To analyze the impact of Tranexamic acid (TXA) on perioperative hemodynamics in craniosynostosis surgery.
- To evaluate the efficacy of TXA in reducing blood loss and transfusion requirements.
- To identify factors associated with postoperative hemodynamic instability.
Main Methods:
- Retrospective analysis of 36 children undergoing craniosynostosis surgery between 2014-2017.
- Patients were divided into groups based on TXA administration.
- Data collected included demographics, hemostasis, metabolic outcomes, blood loss, and hemodynamic parameters.
Main Results:
- TXA administration was associated with significantly lower intraoperative blood loss (p < 0.001) and reduced blood transfusion volumes (p=0.002).
- Postoperative hematocrit declined in all patients, and TXA did not significantly alter postoperative hemodynamic alterations (p=0.090, p=0.112).
- Intraoperative transfusion volume and estimated blood loss were significantly associated with postoperative hemodynamics (p=0.011 and p=0.045, respectively).
Conclusions:
- Intraoperative TXA is effective in managing blood loss and transfusion needs during craniosynostosis surgery.
- Postoperative bleeding remains a concern, and careful monitoring of hemodynamics is essential.
- Consideration of postoperative TXA may be beneficial in cases with high intraoperative transfusion requirements.
