RTI uses cookies to offer you the best experience online. By clicking “accept” on this website, you opt in and you agree to the use of cookies. If you would like to know more about how RTI uses cookies and how to manage them please view our Privacy Policy here. You can “opt out” or change your mind by visiting: http://optout.aboutads.info/. Click “accept” to agree.
Reducing red blood cell transfusion in orthopedic and cardiac surgeries with Antifibrinolytics
A laboratory medicine best practice systematic review and meta-analysis
Derzon, J. H., Clarke, N., Alford, A., Gross, I., Shander, A., & Thurer, R. (2019). Reducing red blood cell transfusion in orthopedic and cardiac surgeries with Antifibrinolytics: A laboratory medicine best practice systematic review and meta-analysis. Clinical Biochemistry, 71, 1-13. https://doi.org/10.1016/j.clinbiochem.2019.06.015
Objectives: To evaluate the effectiveness of antifibrinolytics tranexamic acid (TA), epsilon-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 (TM)) 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 (TM) 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 (TM) recommends the use of topical, intra-articular injection, or intravenous tranexamic acid and the use of epsilon-aminocaproic acid for reducing overuse of red blood cell transfusion.