View : 38 Download: 0

Effects of tranexamic acid based on its population pharmacokinetics in pediatric patients undergoing distraction osteogenesis for craniosynostosis: Rotational thromboelastometry (ROTEM™) analysis

Title
Effects of tranexamic acid based on its population pharmacokinetics in pediatric patients undergoing distraction osteogenesis for craniosynostosis: Rotational thromboelastometry (ROTEM™) analysis
Authors
Kim E.J.Kim Y.O.Shim K.W.Ko B.W.Lee J.W.Koo B.-N.
Ewha Authors
이종화
Issue Date
2018
Journal Title
International Journal of Medical Sciences
ISSN
1449-1907JCR Link
Citation
International Journal of Medical Sciences vol. 15, no. 8, pp. 788 - 795
Keywords
Rotational thromboelastometryTranexamic acidTransfusionCraniosynostosis
Publisher
Ivyspring International Publisher
Indexed
SCIE; SCOPUS WOS scopus
Document Type
Article
Abstract
Background: Distraction osteogenesis for craniosynostosis is associated with significant hemorrhage. Additionally, patients usually require several transfusions. Tranexamic acid (TXA) is effective for reducing blood loss and the need for transfusions during surgeries. However, the significance of TXA infusion has not been thoroughly described yet. Methods: Forty-eight children undergoing distraction osteogenesis for craniosynostosis were administered intraoperative TXA infusion (loading dose of 10 mg/kg for 15 min, followed by continuous infusion at 5 mg/kg/h throughout surgery; n = 23) or normal saline (control, n = 25). Rotational thromboelastometry (ROTEM TM) was conducted to monitor changes in coagulation perioperatively. Results: Blood loss during surgery was significantly lower in the TXA-treated group than it was in the control group (81 vs. 116 mL/kg, P = 0.003). Furthermore, significantly fewer transfusions of red blood cells and fresh frozen plasma were required in the TXA group. In the control group, clotting time during the postoperative period was longer than it was during the preoperative period. Similarly, clot strength was weaker during the postoperative period. D-dimer levels dramatically increased in the control group compared with the TXA group after surgery. The duration of mechanical ventilation and the number of postoperative respiratory-related complications were significantly greater in the control group than they were in the TXA group. Conclusions: TXA infusion based on population pharmacokinetic analysis is effective in reducing blood loss and the need for transfusions during the surgical treatment of craniosynostosis. It can also prevent the increase in D-dimer levels without affecting systemic hemostasis. © Ivyspring International Publisher.
DOI
10.7150/ijms.25008
Appears in Collections:
의과대학 > 의학과 > Journal papers
Files in This Item:
There are no files associated with this item.
Export
RIS (EndNote)
XLS (Excel)
XML


qrcode

Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.

BROWSE