Transfusion medicine
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Transfusion medicine · Jun 2015
Review Meta AnalysisThe effectiveness and safety of tranexamic acid in total hip or knee arthroplasty: a meta-analysis of 2720 cases.
To evaluate the safety and efficacy of tranexamic acid (TXA) in total knee arthroplasty (TKA) and total hip arthroplasty (THA). The specific endpoints assessed in this meta-analysis include the total blood loss, the incidence rate of deep vein thrombosis (DVT) and pulmonary embolisms (PE), the number of patients requiring at least 1 U of red blood cell following surgery. ⋯ To our knowledge, this meta-analysis is more powerful and persuasive than any other published before. It suggests that the use of TXA reduced the risk of blood loss and the need for allogeneic blood transfusion significantly, without apparent increased risk of DVT or PE complications.
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Transfusion medicine · Jun 2012
Review Meta AnalysisThe use of trauma transfusion pathways for blood component transfusion in the civilian population: a systematic review and meta-analysis.
This study was undertaken to determine if, amongst civilian trauma patients requiring massive transfusion (MT), the use of a formal trauma transfusion pathway (TTP), in comparison with transfusion without a TTP, is associated with a reduction in mortality, or changes in indices of coagulation, blood product utilisation and complications. A systematic review of three bibliographic databases, reference lists and conference proceedings was conducted. Studies were included if comparisons were made between patients receiving transfusion with and without a TTP. ⋯ In summary, the use of TTPs appears to be associated with a reduction in mortality amongst trauma patients requiring MT without a clinically significant increase in the number of PRBC transfused and a potential reduction in plasma transfusion. Effects of TTPs on platelet transfusion, indices of coagulation and complications remain unclear. A randomised controlled trial is warranted.
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Transfusion medicine · Dec 1998
Meta AnalysisErythropoietin to minimize perioperative blood transfusion: a systematic review of randomized trials. The International Study of Peri-operative Transfusion (ISPOT) Investigators.
Our aim was to perform a systematic review to determine the efficacy and side-effects of erythropoietin, given with or without autologous predonation, to patients undergoing orthopaedic or cardiac surgery. A number of studies have been done to determine whether erythropoietin minimizes exposure to perioperative allogeneic red cell transfusion. A systematic review of all randomized trials will provide the best estimate of the efficacy and side-effects of erythropoietin therapy. ⋯ Although there was no convincing evidence that erythropoietin used alone increased the frequency of thrombotic complications, some studies found an excess of events in erythropoietin-treated patients, and the number of patients studied was relatively small. Erythropoietin, when given alone or to augment autologous donation, decreased exposure to perioperative allogeneic transfusion in orthopaedic and cardiac surgery. Further studies are required to definitively establish the safety of erythropoietin alone, to determine the optimal dose of perioperative erythropoietin, and to compare its efficacy and cost-effectiveness with other methods of minimizing perioperative transfusion.