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Open Access 01-12-2024 | Tranexamic Acid | Systematic Review

Effectiveness of tranexamic acid in burn patients undergoing surgery – a systematic review and meta-analysis

Authors: Joeri Slob, Rolf K. Gigengack, Margriet E. van Baar, Stephan A. Loer, Seppe S. H. A. Koopman, Cornelis H. van der Vlies

Published in: BMC Anesthesiology | Issue 1/2024

Summary

Background

Reducing blood loss during excisional surgery in burn patients remains a challenge. Tranexamic acid during surgery can potentially reduce blood loss. The use of tranexamic acid during excisional surgery in burn patients has recently been described in a review and meta-analysis. However, quality assessment on studies included was not performed and this review did not apply independent reviewers. Quality assessment of studies investigating the effectiveness of tranexamic acid in burn patients is crucial before concusions can be drawn. Therefore, we conducted a systematic review and meta-analysis of the literature investigating the effectiveness of tranexamic acid in burn patients undergoing surgery.

Methods

A systematic review and meta-analysis of the literature was conducted. The study was pre-registered in PROSPERO database (CRD42023396183).

Results

Five studies including two randomised controlled trials (RCTs) with a total of 303 patients were included. Risk of bias of the included studies was moderate to high. Individual results of the studies were heterogeneous. In three studies of moderate quality the administration of tranexamic acid resulted in a reduction of blood loss per unit excised area, accounting as moderate level of evidence. In two low-quality studies and one moderate quality study the administration of tranexamic acid resulted in a reduction of transfused packed Red Blood Cells (pRBC’s), accounting for moderate level of evidence. Postoperative haemoglobin levels were higher after tranexamic acid administration in one study, accounting for insufficient evidence. Meta-analysis pooling overall blood loss from two separate RCTs failed to detect a statistically significant reduction. Substantial heterogeneity was observed.

Conclusions

Moderate level of evidence indicates that tranexamic acid reduces blood loss per unit of excised area and transfusion of packed Red Blood Cells. Results indicate that tranexamic acid can be beneficial in burn patients undergoing surgery. More high-quality research is needed to confirm these results. Future studies should focus on the dosing of tranexamic acid, the administration approaches, and even consider combining these approaches.

Trial Registration

PROSPERO: CRD42023396183

Available only for authorised users

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Title: Effectiveness of tranexamic acid in burn patients undergoing surgery – a systematic review and meta-analysis
Authors: Joeri Slob
Rolf K. Gigengack
Margriet E. van Baar
Stephan A. Loer
Seppe S. H. A. Koopman
Cornelis H. van der Vlies
Publication date: 01-12-2024
Publisher: BioMed Central
Keyword: Tranexamic Acid
Published in: BMC Anesthesiology / Issue 1/2024
Electronic ISSN: 1471-2253
DOI: https://doi.org/10.1186/s12871-024-02471-3

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Effectiveness of tranexamic acid in burn patients undergoing surgery – a systematic review and meta-analysis

Summary

Background

Methods

Results

Conclusions

Trial Registration

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Summary

Background

Methods

Results

Conclusions

Trial Registration

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