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Cited by 313Blood transfusion and managementCraniofacial Disorders and TreatmentsHemostasis and retained surgical items

The DOI matches its Crossref record; 46 of the 46 references it cites were found in a registry or an index.

Efficacy of Tranexamic Acid in Pediatric Craniosynostosis Surgery: A Double-blind, Placebo-controlled Trial

Goobie, Susan M., Meier, Petra M., Pereira, Luis M., McGowan, Francis X., Prescilla, Randy P., Scharp, Laurie A., Rogers, Gary F., Proctor, Mark R., Meara, John G., Soriano, Sulpicio G., Zurakowski, David, Sethna, Navil F.·2011·Anesthesiology
DOI 10.1097/aln.0b013e318210fd8f
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Abstract

BACKGROUND: Extensive blood loss is common in pediatric craniosynostosis reconstruction surgery. Tranexamic acid (TXA) is increasingly used to reduce perioperative blood loss in various settings, but data on its efficacy are limited in children. The purpose of this randomized, double-blind, placebo-controlled, parallel trial was to evaluate the efficacy of TXA in pediatric craniosynostosis correction surgery. The primary and secondary outcome variables were reduction in perioperative blood loss and reduction in blood transfusion, respectively. METHODS: Forty-three children, ages 2 months to 6 yr, received either placebo or TXA in a loading dose of 50 mg·kg(-1), followed by an infusion of 5 mg·kg·h(-1) during surgery. TXA plasma concentrations were measured. RESULTS: The TXA group had significantly lower perioperative mean blood loss (65 vs. 119 ml·kg(-1), P < 0.001) and lower perioperative mean blood transfusion (33 vs. 56 ml· kg(-1), P = 0.006) compared to the placebo group. The mean difference between the TXA and placebo groups for total blood loss was 54 ml·kg(-1) (95% CI for the difference, 23-84 ml·kg(-1)) and for packed erythrocytes transfused was 23 ml·kg(-1) (95% CI for the difference, 7-39 ml·kg(-1)). TXA administration also significantly diminished (by two thirds) the perioperative exposure of patients to transfused blood (median, 1 unit vs. 3 units; P < 0.001). TXA plasma concentrations were maintained above the in vitro thresholds reported for inhibition of fibrinolysis (10 μg·ml(-1)) and plasmin-induced platelet activation (16 μg·ml(-1)) throughout the infusion. CONCLUSIONS: TXA is effective in reducing perioperative blood loss and transfusion requirement in children undergoing craniosynostosis reconstruction surgery.

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Metadata

Authors
Goobie, S. M., Meier, P. M., Pereira, L. M., McGowan, F. X., Prescilla, R. P., Scharp, L. A., Rogers, G. F., Proctor, M. R., Meara, J. G., Soriano, S. G., Zurakowski, D., & Sethna, N. F.
Affiliations
  • Boston Children's Hospital (US)
  • Instructor in Anesthesia.
  • Massachusetts College of Pharmacy and Health Sciences (US)
  • Professor of Anesthesia.
  • Research Technician, †† Professor.
  • Assistant Professor.
  • Associate Professor, Department of Plastic and Oral Surgery.
  • Assistant Professor of Anaesthesia (Director of Biostatistics).
  • Associate Professor of Anesthesia, Department of Anesthesia, Perioperative, and Pain Medicine.
ORCID
Venue
Anesthesiology
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2011-04-01
Volume
114
Issue
4
Pages
862-871
ISSN
0003-3022 (ISSN-L)
DOI
10.1097/aln.0b013e318210fd8f
OpenAlex
W2016016217
Cited by
313
References
46
Citations by year
2026: 10 · 2025: 13 · 2024: 21 · 2023: 16 · 2022: 22 · 2021: 25 · 2020: 20 · 2019: 26 · 2018: 20 · 2017: 17 · 2016: 19 · 2015: 30 · 2014: 28 · 2013: 17 · 2012: 21
FWCI
15.44
Type
journal article
Language
en
Open access
closed
Locations
  • Anesthesiology (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Hematology › Blood transfusion and management
  • Health Sciences › Medicine › Surgery › Craniofacial Disorders and Treatments
  • Health Sciences › Medicine › Hematology › Hemostasis and retained surgical items
Keywords
tranexamic acid, pediatric craniosynostosis, perioperative blood loss, blood transfusion, fibrinolysis inhibition, plasma drug concentration, children
MeSH terms
Antifibrinolytic Agents, Blood Transfusion, Child, Child, Preschool, Craniosynostoses, Double-Blind Method, Female, Humans, Infant, Intraoperative Care, Male, Tranexamic Acid, Blood Loss, Surgical, Treatment Outcome

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