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Tranexamic acid in burn surgery: A systematic review and meta-analysis. | LitMetric

Tranexamic acid in burn surgery: A systematic review and meta-analysis.

Burns

Anne Burnett Marion School of Medicine, Texas Christian University, 1604 W. Rosedale St., Suite 104, Fort Worth, TX 76104, USA.

Published: September 2023

AI Article Synopsis

  • Severe burn injuries can lead to blood clotting issues and significant fluid loss, requiring aggressive treatment that often results in hemodilution.
  • Tranexamic acid (TXA) is a medication that may help reduce blood loss during burn surgeries, but its effectiveness wasn't fully understood until this study.
  • The analysis found that TXA significantly decreased total blood loss and the need for blood transfusions during these surgeries, with no increase in complications like blood clots or mortality.

Article Abstract

Burn injury causes a coagulopathy that is poorly understood. After severe burns, significant fluid losses are managed by aggressive resuscitation that can lead to hemodilution. These injuries are managed by early excision and grafting, which can cause significant bleeding and further decrease blood cell concentration. Tranexamic acid (TXA) is an anti-fibrinolytic that has been shown to reduce surgical blood losses; however, its use in burn surgery is not well established. We performed a systematic review and meta-analysis to investigate the influence TXA may have on burn surgery outcomes. Eight papers were included, with outcomes considered in a random-effects model meta-analysis. Overall, when compared to the control group, TXA significantly reduced total volume blood loss (mean difference (MD) = -192.44; 95% confidence interval (CI) = -297.73 to - 87.14; P = 0.0003), the ratio of blood loss to burn injury total body surface area (TBSA) (MD = -7.31; 95% CI = -10.77 to -3.84; P 0.0001), blood loss per unit area treated (MD = -0.59; 95% CI = -0.97 to -0.20; P = 0.003), and the number of patients receiving a transfusion intraoperatively (risk difference (RD) = -0.16; 95% CI = -0.32 to - 0.01; P = 0.04). Additionally, there were no noticeable differences in venous thromboembolism (VTE) events (RD = 0.00; 95% CI = -0.03 to 0.03; P = 0.98) and mortality (RD = 0.00; 95% CI = -0.03 to 0.04; P = 0.86). In conclusion, TXA can potentially be a pharmacologic intervention that reduces blood losses and transfusions in burn surgery without increasing the risk of VTE events or mortality.

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Source
http://dx.doi.org/10.1016/j.burns.2023.05.009DOI Listing

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