Document Detail


Antifibrinolytics in major orthopaedic surgery.
MedLine Citation:
PMID:  20190103     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Total joint arthroplasty and deformity surgery of the spine can require complex reconstructive procedures accompanied by the potential for major blood loss. In an attempt to minimize the perioperative blood loss associated with these procedures, recent focus has concentrated on the efficacy of pharmacologic agents. Antifibrinolytics such as epsilon-aminocaproic acid, tranexamic acid, and aprotinin have been shown to reduce perioperative blood loss, autologous blood donation, transfusions, and associated costs in cardiac as well as major orthopaedic surgery. These agents reduce perioperative blood loss by inhibition of clot breakdown. Prospective, randomized studies have shown that the use of these agents can be effective in reducing the perioperative blood loss and transfusion requirements in total joint arthroplasty, pediatric scoliosis surgery, and adult reconstructive surgery of the spine. Aprotinin, however, is currently under suspension from use pending further evaluation of a trial. Although concerns exist about increased thrombotic events with the use of these agents, large meta-analyses suggest that antifibrinolytics can be safely and efficaciously employed to decrease perioperative blood loss and transfusion requirements.
Authors:
Jason David Eubanks
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  The Journal of the American Academy of Orthopaedic Surgeons     Volume:  18     ISSN:  1067-151X     ISO Abbreviation:  J Am Acad Orthop Surg     Publication Date:  2010 Mar 
Date Detail:
Created Date:  2010-03-01     Completed Date:  2010-05-04     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9417468     Medline TA:  J Am Acad Orthop Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  132-8     Citation Subset:  IM    
Affiliation:
Department of Orthopaedic Surgery, University Hospital Case Medical Center, Cleveland, OH, USA.
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MeSH Terms
Descriptor/Qualifier:
6-Aminocaproic Acid / adverse effects,  therapeutic use
Antifibrinolytic Agents / adverse effects,  therapeutic use*
Aprotinin / adverse effects,  therapeutic use
Blood Loss, Surgical / prevention & control*
Blood Transfusion
Humans
Orthopedic Procedures*
Postoperative Hemorrhage / prevention & control*
Reconstructive Surgical Procedures
Tranexamic Acid / adverse effects,  therapeutic use
Chemical
Reg. No./Substance:
0/Antifibrinolytic Agents; 1197-18-8/Tranexamic Acid; 60-32-2/6-Aminocaproic Acid; 9087-70-1/Aprotinin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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