From: Tranexamic acid and the reduction of blood loss in total knee and hip arthroplasty: a meta-analysis
Study, Year | Patients lost to follow-up and/or excluded after randomization | Dose of TXA | Method of TXA administration | Control | Transfusion criteria | Method of measuring blood loss | Deep vein thrombosis screening method | DVT prophylaxis |
---|---|---|---|---|---|---|---|---|
Benoni, 2000[29] | 1 | 10 mg/kg at end of operation + again three hours later. | IV | S | Clinical condition | Swabs + drain | Clinical exam. | Klexane. |
Benoni, 2001[33] | 2 | 10 mg/kg - max = 1 gram over 5–10 minutes, immediately before operation started. | IV | S | Clinical decision. Usually Hb < 80–100 g/L. | Swabs + drain | Clinical exam. | Klexane. |
Husted, 2003[25] | 0 | 10 mg/kg for 10 minutes, 15 minutes prior to incision + 1 mg/kg/hr for 10 hours. | IV | S | Hb < 25% + clinical symptoms. | Drain + transfusions + swabs | Clinical exam +/− ultrasound + follow-up 3 months post-op. | Low molecular weight heparin. |
Yamasaki, 2004[40] | 0 | 1000 mg 5 minutes prior to operation. | IV | Non-TXA | N/R | Swabs + drain | Clinical exam + ascending phlebography. | None |
Garneti, 2004[14] | 0 | 10 mg/kg. | IV | S | N/R | Swabs + drain | Belfast scan, duplex scan or venogram - fifth postoperative day. | DTV stockings + foot pumps. |
Lemay, 2004[34] | 1 | Test dose 1 mL. 10 mg/kg prior to surgery. 1 mg/kg/hr infusion until wound closure. | IV | S | 90 g/L or 70 g/L – dependant on patient. | Swabs + drain | Clinical exam daily + ultrasound of both inferior limbs between post-op days 5–10 or earlier if symptoms present. | Dalteparin. |
Johansson, 2005[26] | 19 | 15 mg/kg single injection. | IV | S | Hb < 90 g/L | Swabs + drain + Hb balance method. | Clinical exam +/−ultrasound. | Fragmin. |
Niskanen, 2005[30] | 1 | Three doses of 10 mg/kg. 1st over 5–10 minutes immediately before operation. 2nd + 3rd, 8 hrs + 16 hours after operation | IV | S | Hct 28% - 30% + clinical situation | Swabs + drain | Clinical exam +/− ultrasound. | Dalteparin. |
Claeys, 2007[32] | 0 | 15 mg/kg. | IV | S | Hb < 85 g/L or Hemocrit < 27%. | Swabs + drain | Clinical exam daily + ultrasound on tenth postoperative day. | Fraxiparine. |
Kazemi, 2010[8] | 0 | 15 mg/kg slowly 5 minutes pre-operatively | IV | S | Used allowable blood loss formula. | Swabs + drain | Clinical exam. | Enoxaparin. |
Malhotra, 2011[20] | 0 | 15 mg/kg 15 minutes prior to surgery. | IV | S | Reduction in Hb exceeding 25% + clinical symptoms. | Swabs + drain | Colour ultrasound on tenth post-op day. | Low molecular weight heparin + elastic leg dressing. |
McConnell, 2011[38] | 0 | 10 mg/kg bolus at start of surgery. | IV | Non-TXA | N/R | Change in hemocrit method. | N/R | Stockings + early mobilization + aspirin |
Imai, 2012[39] |  | 1 g 1) 10 minutes prior to skin closure 2) and again 2 hours later. 1 g 3) 10 minutes before surgery 4) and again 6 hours later. | IV | Non-TXA | N/R | Change in hemocrit method. | Whole body CT on 7th postoperative day. | Stockings + enoxaparin |