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Z Orthop Unfall 2023; 161(05): 532-537
DOI: 10.1055/a-2055-8178
Review

The Perioperative Application of Tranexamic Acid

Recommendation of the Working Group Endoprosthetics in Cooperation with an Expert Group of the German Society for Anesthesiology and Intensive Care Medicine Update February 2023 Article in several languages: English | deutsch

Authors

  • Carsten Perka

    1   Klinik für Orthopädie, Centrum für Muskuloskeletale Chirurgie, Charité - Universitätsmedizin Berlin, Berlin, Deutschland (Ringgold ID: RIN14903)

  • Christian von Heymann

    2   Klinik für Anästhesie, Intensivmedizin, Notfallmedizin und Schmerztherapie, Vivantes Klinikum im Friedrichshain, Berlin, Berlin, Deutschland

  • Heiko Lier

    3   Klinik für Anästhesiologie und Operative Intensivmedizin, Medizinische Fakultät und Uniklinik Köln, Köln, Deutschland

  • Lutz Kaufner

    4   Klinik für Anästhesiologie mit Schwerpunkt operative Intensivmedizin, Charité ‒ Universitätsmedizin Berlin, Berlin, Deutschland (Ringgold ID: RIN14903)

  • Sascha Treskatsch

    4   Klinik für Anästhesiologie mit Schwerpunkt operative Intensivmedizin, Charité ‒ Universitätsmedizin Berlin, Berlin, Deutschland (Ringgold ID: RIN14903)
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Abstract

The application of tranexamic acid (TXA) during endoprosthetic surgical procedures has significantly increased in recent years. Due its ability to reduce perioperative blood loss and avert the need for blood transfusions as well as wound drainage, TXA is becoming part of a ‘standard practice’. However, TXA is currently not approved for the application during endoprosthetic procedures and therefore, a benefit-risk analysis should always be conducted. Prophylactic administration of TXA without prior patient consent is only justified if fibrinolytic bleeding is expected and there are no contraindications or relevant risk factors for thromboembolic complications. Respectively, no patient consent is required when a therapeutic dose of TXA is administered in the context of fibrinolytic bleeding. The following guidelines provide updated recommendations based on the current state of knowledge on TXA optimal timing, routes of administration and dosing regimen.

Keywords

tranexamic acid - fibrinolysis - hyperfibrinolysis - blood loss


Publication History

Article published online:
19 June 2023

© 2023. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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