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A Journal on Anesthesiology, Resuscitation, Analgesia and Intensive Care
Minerva Anestesiologica 2017 April;83(4):353-60
Copyright © 2016 EDIZIONI MINERVA MEDICA
Transfusion requirements in burn patients undergoing primary wound excision: effect of tranexamic acid
Ana DOMÍNGUEZ 1 ✉, Estíbaliz ALSINA 1, Luis LANDÍN 2, Javier F. GARCÍA-MIGUEL 3, Cesar CASADO 2, Fernando GILSANZ 1
1 Burn Center, Department of Anesthesia and Intensive Care, La Paz University Hospital, Madrid, Spain; 2 Burn Center, Department of Plastic, Cosmetic and Reconstructive Surgery, La Paz University Hospital, Madrid, Spain; 3 Department of Anesthesia and Intensive Care, Segovia General Hospital, Segovia, Spain
BACKGROUND: Early excision of burn wounds is the standard approach for burns, but it is usually associated with the need of allogeneic blood transfusion. Our aim was to determine if intravenous administration of tranexamic acid (TXA) was able to reduce packed red blood cell (pRBC) transfusion requirements in burn patients.
METHODS: We conducted a retrospective cohort study of 2 consecutive series of severely burned patients (≥20% total body surface are) admitted for primary burn surgery. We searched for differences in pRBC transfusion occurrence and requirements during surgery and up to 24 hours after surgery.
RESULTS: A total of 107 patients were included in the study, and 48.6% (52 patients) received TXA during primary excision. The use of TXA exhibited an absolute risk reduction in the need for transfusion during surgery of 24.2% (95% CI: 7.1-41.4%). In total, patients receiving TXA required 1.6 units of pRBC in the perioperative period vs. 2.6 units in those not receiving TXA (P=0.017).
CONCLUSIONS: The intraoperative use of TXA in burn patients undergoing primary burn excision reduced the incidence of allogeneic transfusion and the total number of pRBC transfused.
KEY WORDS: Operative blood salvage - Blood transfusion - Tranexamic acid - Wounds and injuries - Burns