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Reducing red blood cell transfusion in orthopedic and cardiac surgeries with Antifibrinolytics: A laboratory medicine best practice systematic review and meta-analysis

  • James H. Derzon
  • , Nicole Clarke
  • , A. Alford
  • , I. Gross
  • , A. Shander
  • , Robert Thurer

Research output: Contribution to journalReview articlepeer-review

3 Scopus citations

Abstract

Objectives: To evaluate the effectiveness of antifibrinolytics tranexamic acid (TA), ε-aminocaproic acid (EACA), and aprotinin to decrease overuse of red blood cell transfusions in adult surgical and non-surgical patients. Methods: This review followed the Centers for Disease Control and Prevention (CDC) Laboratory Medicine Best Practice (LMBP™) Systematic Review (A-6) method. Eligible studies were assessed for evidence of effectiveness of TA or EACA in reducing the number of patients transfused or the number of whole blood transfusions. Results: Seventy-two articles met LMBP™ inclusion criteria. Fifty-six studies assessed Topical, Intra-articular Injection, or Intravenous TA, 4 studied EACA, and 12 studied the effectiveness of aprotinin. The overall strength of the body of evidence of effectiveness for each of these practices was rated as high. Conclusion: LMBP™ recommends the use of topical, intra-articular injection, or intravenous tranexamic acid and the use of ε-aminocaproic acid for reducing overuse of red blood cell transfusion.

Original languageEnglish
Pages (from-to)1-13
Number of pages13
JournalClinical Biochemistry
Volume71
DOIs
StatePublished - Sep 2019
Externally publishedYes

Keywords

  • Antifibrinolytics
  • Meta- analysis
  • Red blood cell transfusion
  • Systematic review
  • Tranexamic acid
  • ε-Aminocaproic acid

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