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
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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“They have the advantage of requiring fewer skin incisions and less blood loss and are therefore considered less invasive and more child-friendly [64,65,66,67,68,69,70].”
From Isolated Sagittal Craniosynostosis: A Comprehensive Review (2024) · cites this paper as [65]
Citations
Cites
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Topical Application of Tranexamic Acid Reduces Postoperative Blood Loss in Total Knee Arthroplasty
Wong, J., Abrishami, A., Beheiry, H. E., Mahomed, N. N., Davey, J. R., Gandhi, R. A., Syed, K., Hasan, S. M. O., Silva, Y. D., & Chung, F. F. (2010) · Journal of Bone and Joint Surgery · doi:10.2106/jbjs.i.01518 · Cited by 491
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Tranexamic Acid Reduces Intraoperative Blood Loss in Pediatric Patients Undergoing Scoliosis Surgery
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A Randomized Trial of Tranexamic Acid to Reduce Blood Transfusion for Scoliosis Surgery
Neilipovitz, D., Murto, K., Hall, L. W., Barrowman, N. J., & Splinter, W. M. (2001) · Anesthesia & Analgesia · doi:10.1097/00000539-200107000-00018 · Cited by 256
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Pharmacokinetics of Tranexamic Acid during Cardiopulmonary Bypass
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Rossaint, R., Bouillon, B., Černý, V., Coats, T., Duranteau, J., Fernández‐Mondejar, E., Filipescu, D. C., Hunt, B. J., Komadina, R., Nardi, G., et al. (2016) · Critical Care · doi:10.1186/s13054-016-1265-x · Cited by 1,495
Spahn, D. R., Bouillon, B., Černý, V., Duranteau, J., Filipescu, D. C., Hunt, B. J., Komadina, R., Maegele, M., Nardi, G., Riddez, L., et al. (2019) · Critical Care · doi:10.1186/s13054-019-2347-3 · Cited by 1,323
“Paediatric patients were not included in the CRASH-2 study; however, an ongoing study is investigating the use of TXA in children [491] and a study in children undergoing craniosynostosis surgery [492, 493] administered an initial bolus of 15–30mg/kg followed by 2−10mg/kg/h.”
BackgroundEffect of tranexamic acid on surgical bleeding: systematic review and cumulative meta-analysis
Ker, K., Edwards, P. J., Perel, P., Shakur‐Still, H., & Roberts, I. (2012) · BMJ · doi:10.1136/bmj.e3054 · Cited by 997
Management of severe perioperative bleeding
Kozek‐Langenecker, S. A., Afshari, A., Albaladejo, P., Aldecoa, C., ROBERTIS, E. D., Filipescu, D. C., Fries, D. R., Görlinger, K., Haas, T., Imberger, G. L., et al. (2013) · European Journal of Anaesthesiology · doi:10.1097/eja.0b013e32835f4d5b · Cited by 911
Apfelbaum, J. (2015) · Anesthesiology · doi:10.1097/aln.0000000000000463 · Cited by 636
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
- Published
- 2011-04-01
- Volume
- 114
- Issue
- 4
- Pages
- 862-871
- ISSN
- 0003-3022 (ISSN-L)
- 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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