Does tranexamic acid reduce transfusion requirements in children with cerebral palsy undergoing osteotomies? A systematic review and meta-analysis.
J Orthop
; 58: 66-74, 2024 Dec.
Article
em En
| MEDLINE
| ID: mdl-39055284
ABSTRACT
Introduction:
Children with cerebral palsy have postural alterations and hip displacements are common among them, for which osteotomies must be carried out, involving great blood loss. Tranexamic acid (TXA), a fibrinolysis inhibitor, has been shown to reduce bleeding in osteotomies. However, the effectiveness of TXA in children with cerebral palsy has not been well studied, so a comprehensive meta-analysis is required to evaluate its impact.Objective:
We conducted a meta-analysis to investigate the effectiveness of tranexamic acid administration in reducing blood loss and transfusions during osteotomies in children with cerebral palsy.Methods:
Databases were searched until April 17, 2024, for randomized controlled trials and observational cohort studies comparing TXA use versus a control group. The primary outcome was overall transfusion.Secondary outcomes included intraoperative transfusion, postoperative transfusion, postoperative hemoglobin (Hb), postoperative hematocrit (Hct), drop in Hct, drop in Hb, length of stay, total blood loss (TBL) and estimated blood loss (EBL). The analysis utilized pooled relative risk ratios (RR) for categorical variables, and mean diï¬erence (MD) for numerical variables. We utilized the ï¬xed-eï¬ects model utilizing the Mantel-Haenszel method.Results:
The analysis included 7 articles, which collectively provided data on 943 patients. It was found thatTXA administration decreases overall transfusion rate (RR = 0,65, 95 % CI 0.47 to 0,90, p = 0,008),postoperative transfusion rate (RR = 0.53, 95 % CI 0.36 to 0,79, p = 0.002) and TBL (MD = -139,41, 95 % CI 221,34 to -57,48, p = 0,0009). There was less length of stay in the control group (MD = 0,47, 95 % CI 0.10 to0,84, p = 0,01). TXA doesn't demonstrate signiï¬cant diï¬erences in EBL, intraoperative transfusion rate, postoperative Hb, postoperative Hct, drop in Hct or drop in Hb.Conclusion:
TXA reduces the need of transfusion and total blood loss and increased length of hospital stay. And TXA doesn't demonstrate signiï¬cant diï¬erences in EBL, intraoperative transfusion rate, postoperative Hb, postoperative Hct, drop in Hct or drop in Hb.
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Coleções:
01-internacional
Base de dados:
MEDLINE
Idioma:
En
Ano de publicação:
2024
Tipo de documento:
Article