• J. Cardiothorac. Vasc. Anesth. · Mar 2020

    Review

    Current Evidence and Future Directions of Tranexamic Acid Use, Efficacy, and Dosing for Major Surgical Procedures.

    • Jason Taam, Qi Joy Yang, K Sandy Pang, Paul Karanicolas, Stephen Choi, Marcin Wasowicz, and Angela Jerath.
    • Department of Anesthesia, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.
    • J. Cardiothorac. Vasc. Anesth. 2020 Mar 1; 34 (3): 782-790.

    AbstractTranexamic acid reduces blood loss and transfusion requirements with no significant thrombotic adverse effects. Postoperative seizures have been seen in cardiac surgical patients in association with patient (advanced age, underlying neurologic disease, chronic kidney disease); surgical (open cardiac procedures, long bypass times); and drug (high tranexamic acid dose) risk factors. Tranexamic acid dosing regimens should be decreased in patients with chronic kidney dysfunction secondary to reduced clearance and drug accumulation. Optimal dosing for cardiac surgical patients has been recommended. Additional research is required to determine dosing regimens in major noncardiac surgery and plasma concentration levels associated with inducing seizures.Copyright © 2019 Elsevier Inc. All rights reserved.

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