Efficacy of Tranexamic Acid in Pediatric Craniosynostosis Surgery

• DOI: 10.1097/aln.0b013e318210fd8f
• Publication Date: 2011-03-02T00:56:47Z
• Authors: Susan M. Goobie; Petra M. Meier; Luis M. Pereira; Francis X. McGowan; Randy P. Prescilla; Laurie A. Scharp; Gary F. Rogers; Mark R. Proctor; John G. Meara; Sulpicio G. Soriano; David Zurakowski; Navil F. Sethna
• Keywords: Male; Intraoperative Care; Blood Loss, Surgical; Infant; Antifibrinolytic Agents; 3. Good health; Craniosynostoses; 03 medical and health sciences; Treatment Outcome; 0302 clinical medicine; Double-Blind Method; Tranexamic Acid; Child, Preschool; Humans; Blood Transfusion; Female; Child

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