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Article

Intravenous Tranexamic Acid Reduces Blood Loss and Transfusion Volume in Scoliosis Surgery for Spinal Muscular Atrophy: Results of a 20-Year Retrospective Analysis

by 1,2,3,4, 1,2,3,5, 6,7, 1,5, 8,9,10,11, 8,9, 1,5, 12 and 1,2,3,5,13,*
1
Department of Orthopaedic Surgery, Kaohsiung Medical University Hospital, Kaohsiung 807, Taiwan
2
Orthopaedic Research Centre, Kaohsiung Medical University, Kaohsiung 807, Taiwan
3
Regenerative Medicine and Cell Therapy Research Center, Kaohsiung Medical University, Kaohsiung 807, Taiwan
4
Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan
5
Department of Orthopaedics, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan
6
Department of Orthopedics, Taipei Medical University Hospital, Taipei 11031, Taiwan
7
Department of Orthopaedics, School of Medicine, College of Medicine, Taipei Medical University, Taipei 11031, Taiwan
8
Department of Pediatrics, Kaohsiung Medical University Hospital, Kaohsiung 807, Taiwan
9
Department of Pediatrics, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan
10
Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan
11
Department of Laboratory Medicine, Kaohsiung Medical University Hospital, Kaohsiung 807, Taiwan
12
Clinical Medicine Research Center, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chia-Yi City 600, Taiwan
13
Department of Orthopaedics, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, Kaohsiung 812, Taiwan
*
Author to whom correspondence should be addressed.
Academic Editor: Paul B. Tchounwou
Int. J. Environ. Res. Public Health 2021, 18(19), 9959; https://doi.org/10.3390/ijerph18199959
Received: 29 July 2021 / Revised: 17 September 2021 / Accepted: 19 September 2021 / Published: 22 September 2021
Intravenous tranexamic acid (TXA) has been administered to reduce intraoperative blood loss in scoliosis surgery. However, the therapeutic effect of TXA on spinal muscular atrophy (SMA) scoliosis surgery is not well demonstrated. Therefore, this study aimed to assess the efficacy of intravenous TXA in SMA scoliosis surgery. From December 1993 to August 2020, 30 SMA patients who underwent scoliosis surgery (posterior fusion with fusion level of thoracic second or third to pelvis) were retrospectively enrolled and divided into the TXA group and non-TXA (control) group, with 15 patients in each group. Survey parameters were the amount of blood loss, blood transfusion, crystalloid transfusion volume, intubation time, and associated pulmonary complications (including pneumonia, pulmonary edema, and pulmonary atelectasis). The TXA group had significantly lesser blood loss than the control group (p = 0.011). Compared with the control group, the TXA group had significantly lower blood transfusion (p < 0.001), crystalloid volume (p = 0.041), and total transfusion volume (p = 0.005). In addition, the TXA group had fewer postoperative pulmonary complications, and patients with pulmonary complications were associated with a higher relative crystalloid volume and relative total transfusion volume (p = 0.003 and 0.022, respectively). In conclusion, TXA can be effective in reducing intraoperative blood loss and crystalloid fluid transfusions during scoliosis surgery in SMA patients, which may aid in reducing postoperative pulmonary complications. View Full-Text
Keywords: blood loss; scoliosis surgery; spinal muscular atrophy; tranexamic acid; transfusion volume blood loss; scoliosis surgery; spinal muscular atrophy; tranexamic acid; transfusion volume
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MDPI and ACS Style

Chou, S.-H.; Lin, S.-Y.; Wu, M.-H.; Tien, Y.-C.; Jong, Y.-J.; Liang, W.-C.; Lu, Y.-M.; Shih, C.-L.; Lu, C.-C. Intravenous Tranexamic Acid Reduces Blood Loss and Transfusion Volume in Scoliosis Surgery for Spinal Muscular Atrophy: Results of a 20-Year Retrospective Analysis. Int. J. Environ. Res. Public Health 2021, 18, 9959. https://doi.org/10.3390/ijerph18199959

AMA Style

Chou S-H, Lin S-Y, Wu M-H, Tien Y-C, Jong Y-J, Liang W-C, Lu Y-M, Shih C-L, Lu C-C. Intravenous Tranexamic Acid Reduces Blood Loss and Transfusion Volume in Scoliosis Surgery for Spinal Muscular Atrophy: Results of a 20-Year Retrospective Analysis. International Journal of Environmental Research and Public Health. 2021; 18(19):9959. https://doi.org/10.3390/ijerph18199959

Chicago/Turabian Style

Chou, Shih-Hsiang, Sung-Yen Lin, Meng-Huang Wu, Yin-Chun Tien, Yuh-Jyh Jong, Wen-Chen Liang, Yen-Mou Lu, Chia-Lung Shih, and Cheng-Chang Lu. 2021. "Intravenous Tranexamic Acid Reduces Blood Loss and Transfusion Volume in Scoliosis Surgery for Spinal Muscular Atrophy: Results of a 20-Year Retrospective Analysis" International Journal of Environmental Research and Public Health 18, no. 19: 9959. https://doi.org/10.3390/ijerph18199959

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