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Speaker notes safety and efficacy of TXA for reducing blood loss in TJR
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ORLANDO, Fla. — The use of tranexamic acid in total joint replacement successfully reduces blood loss both topically and intravenously, and more surgeons should adopt the antifibrinolytic for these procedures, according to a presenter at the Current Concepts in Joint Replacement Winter Meeting, here.
“My current protocol is 1 gram [intravenously] IV, 50 cc at the incision and 1 gram at closure. I use no pre-donation or drains. My transfusion rate is less than 1% [and] you have less bruising and less ecchymosis,” David F. Dalury, MD, said during his presentation. “We need more data on the topical vs. IV [tranexamic acid], but I think it is something that should be considered state of the art in total knee replacement and total hip replacement in 2013.”
David F. Dalury
Although attempts to minimize blood loss through methods such as drains, tourniquets and blood donations have had mixed success, Dalury said the antifibrinolytics, particularly tranexamic acid (TXA), have had success in reducing blood loss.
“The drug can be pre-mixed by the pharmacy. It is stable and sterile for 24 hours, and you can have it delivered to the operating room for your use,” Dalury said.
He also said that TXA is cost effective, noting that it costs $50 to make in his hospital. He also cited a recently published study that showed total hospital costs were less for patients who received TXA acid compared to patients who did not receive the antifibrinolytic. – by Jeff Craven
Reference:
Dalury DF. Paper #87. Presented at: Current Concepts in Joint Replacement Winter Meeting; Dec. 12-14, 2013; Orlando, Fla.
Disclosure: Dalury receives royalties from and is a paid consultant for DePuy.