This Article Résumé de cet Article Full Text Full Text (PDF) Submit a scholarly reply Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Lemay, E. Articles by Roy, A. Search for Related Content PubMed PubMed Citation Articles by Lemay, E. Articles by Roy, A.

Tranexamic acid reduces the need for allogenic red blood cell transfusions in patients undergoing total hip replacement

[L’acide tranexamique réduit les besoins de transfusion sanguine allogénique chez les patients devant subir une arthroplastie totale de la hanche]

Erik Lemay, MD FRCPC^*, Joanne Guay, MD FRCPC^*, Christiane Côté, RN^* and Alain Roy, MD FRCPC

^* From the Departments of Anesthesiology,
and Surgery, Maisonneuve-Rosemont Hospital, University of Montreal, Montreal, Quebec, Canada.

Address correspondence to: Dr. Joanne Guay, Département d’anesthésie-réanimation, Hôpital Maisonneuve-Rosemont, 5415, boul. l’Assomption, Montréal, Québec H1T 2M4, Canada. Phone: 514-252-3426; Fax: 514-252-3542; E-mail : joanne.guay{at}umontreal.ca

Purpose: This prospective randomized double-blind trial evaluates the efficacy of tranexamic acid (TA) to decrease blood losses and red blood cell transfusions in patients undergoing primary unilateral total hip replacement (THR).

Methods: Forty ASA class I to III patients received either iv TA 10 mg•kg^-1 bolus before surgery plus a 1 mg•kg^-1•hr^-1 infusion until wound closure (Group TA) or a placebo (Group P). Red blood cell transfusions were administered according to a standardized protocol.

Results: One patient of Group P was excluded because of an erroneous diagnosis at enrollment. Total measured blood losses (Group TA: 1308 ± 462 mL vs Group P: 1469 ± 405 mL), preoperative hemoglobin levels (Group TA: 130.4 ± 12.5 g•L^-1 vs Group P: 131.4 ± 12.8 vs g•L^-1), and seven-day postoperative hemoglobin values (Group TA: 97.8 ± 11.8 g•L^-1 vs Group P: 102.9 ± 12.2 g•L^-1) were similar. Autologous whole blood was available in five patients of Group P and seven patients of Group TA. Fewer patients in Group TA required red blood cells (Group TA: 6/20 vs Group P: 13/19; P = 0.026) and allogenic red blood cell transfusions (Group TA: 0/20 vs Group P: 8/19; P = 0.0012). The median number of transfused unit per patient was also significantly less in patients of Group TA (0 unit) than in Group P (2 units; P = 0.03).

Conclusion: TA did not change measured blood losses but reduced red blood cell transfusion requirements in patients undergoing primary unilateral THR.