JBI Database of Systematic Reviews & Implementation Reports JBLOLL ; 11(5)
|
|
- Leon Watts
- 5 years ago
- Views:
Transcription
1 Effectiveness of intravenous Tranexamic Acid (TXA) administration in managing perioperative blood loss in patients undergoing spine surgery: a systematic review protocol Jennifer Badeaux CRNA, MN 1 Diane Hawley PhD, RN, ACNS-BC, CCNS, CNE 1 1. Texas Christian University (TCU) Center for Evidence Based Practice and Research: A Collaborating Center of the Joanna Briggs Institute Corresponding Author: Jennifer Badeaux jbadea@lsuhsc.edu Review question/objective Is the intravenous administration of tranexamic acid (TXA) effective in the management of blood loss during the perioperative phase of spine surgery? The objective of this review is to identify the effectiveness of intravenous TXA administration in managing perioperative blood loss in patients undergoing spine surgery. Background The fundamental role of the spinal column as the human body s supporting axis has been a subject of medical study for centuries. References to spinal column treatment date back to ancient times. Hippocrates ( B.C.) is regarded as the father of spine surgery because of the two apparatuses he discovered to reduce displaced vertebrae. They are considered to be the precursors to the sophisticated techniques used in spine surgery today. 1 In 1814, Clyne was documented to have made the first incision into the spine which subsequently resulted in complications associated with blood loss. 2 Today, patients of all ages undergo an array of spinal procedures with prodigious results, yet practitioners continue to fight the battle of surgical blood loss which can lead to negative patient outcomes. 3 The spine is composed of vertebrae, intervertebral discs, the spinal cord, and vascular structures which are all supported by ligaments. There are a total of 33 spinal vertebrae which include seven cervical, 12 thoracic, five lumbar, five sacral and four coccygeal vertebrae. Numerous surgical procedures are performed on all areas of the spine which include but are not limited to anterior and posterior spinal Page 123
2 fusions, microdiscectomy, laminectomy, and kyphoplasty. The most common indications for spinal surgical procedures are: spinal instability, fracture, stenosis, degenerative disease, tumor resection or removal, disc herniation, vertebral osteomylitis, tuberculosis, scoliosis and failed previous spinal fusions. 4 Improvements in surgical techniques and technologies which have evolved over centuries have afforded surgeons the opportunity to perform extremely complex spinal surgeries on patients of any age. Although spinal surgery is performed routinely, it is associated with a considerable amount of blood loss and subsequent allogeneic blood transfusions. This is particularly true for surgical procedures performed for spinal malformation, procedures involving bone grafting from the pelvic bone, metal implantation, and combined anterior and posterior spinal procedures. 5 Several patient and procedural factors are known to affect intraoperative and postoperative blood loss, which will be collectively referred to as perioperative blood loss in this review. Contributing patient factors are patient height, perioperative mean arterial blood pressure and coagulation status. 6 Contributing procedural factors include length and technique of surgical procedure, number of vertebral levels involved, anesthetic technique, and use of anti-fibrinolytic medications. 3 Blood loss in spinal surgery is variable and can lead to devastating outcomes if it is not controlled. Large-vein bleeding is the major source of blood loss and its persistence can lead to enhanced fibrinolysis which is a potential contributing factor to blood loss during spinal surgery. 6 Although the cause of blood loss is multifactorial, the initiation of blood clotting and fibrinolysis does not discriminate between different age groups. Blood loss associated with spinal surgery is a common cause of patient morbidities such as pulmonary and cerebral edema due to fluid shifts. 5 Blood transfusions are often required to maintain tissue perfusion and prevent end-organ damage when a significant quantity of intra-operative and postoperative blood is lost. Therefore, patients may be subjected to the known risks of blood transfusion including transmission of diseases, transfusion-related reactions, immune suppression, and a decrease in coagulation factors. 8,9 Different techniques including hypotensive anesthesia, preoperative autologous blood donation, acute normovolemic hemodilution, perioperative blood salvage, and the prophylactic administration of synthetic antifibrinolytic drugs such as Aprotinin, epsilon aminocaproic acid (EACA) and TXA have been suggested to minimize intraoperative and postoperative blood loss and the need for blood transfusion requirements during spinal surgery. 7 Aprotinin was shown to be effective in slowing down fibrinolysis, but after it was associated with increased mortality compared with TXA in a large randomized controlled trial in high-risk cardiac surgery (RR = 1.55; 95% CI, it was removed from the market and is no longer commercially available in the United States. 10,11 EACA has been shown to be effective but is associated with hypotension, cardiac arrhythmias, myopathy, and rhabdomyolysis. TXA is also considered to have 10 times the potency of EACA. 12 The perioperative administration of TXA is of particular interest in spinal surgery because it is the most promising alternative to either Aprotinin or EACA due to its fewer side effects and favorable benefit-risk ratio. 13,14 The increased risk of thrombolytic events with TXA has not been shown in clinical trials. 15 TXA is a synthetic derivative of the amino acid lysine and can be used to treat or prevent excessive blood loss during surgery. 16 It is an antifibrinolytic that competitively inhibits the activation of plasminogen to plasmin, by binding to specific sites of both plasminogen and plasmin, a molecule responsible for the degradation of fibrin. 12,15,17 Fibrin is a protein that forms the framework of blood clots. 15 Since the Page 124
3 introduction of TXA in the 1960s, several randomized controlled trials and systematic reviews have been published to support the effectiveness of administering antifibrinolytic drugs to reduce perioperative blood loss in cardiac and orthopedic procedures. 11,16,18 More recent studies have shown the effectiveness of TXA administration in the reduction of blood loss in patients undergoing spine surgeries. Shapiro et al noted that TXA significantly reduced (p<0.001) both perioperative blood loss and allogeneic blood transfusion requirements in spine fusions for treatment of scoliosis in patients with Duchenne muscular dystrophy. 19 Elwatidy et al found that the prophylactic use of high-dose TXA was an effective, safe and inexpensive method for reducing blood loss during and after spine operations. 20 Wong et al reported significantly reduced (p = 0.017) perioperative blood loss during elective posterior thoracic or lumbar spine fusion with instrumentation in adults. 21 A systematic review published in 2008 considered randomized controlled trials to evaluate the effect of antifibrinolytics on perioperative blood loss in children who were 18 years of age or younger undergoing scoliosis surgery. 22 A 2008 meta-analysis conducted by Gill et al evaluated antifibrinolytic agents and the reduction of blood loss and blood transfusions in patients undergoing spine surgery. 23 The meta-analysis focused on all antifibrinolytic agents, whereas this review will focus only on TXA and include not only randomized controlled trials but also observational studies. Keywords Tranexamic acid; Tranexamic; Cyclohexanecarboxylic; Spine surgery; Diskectomy; Laminectomy; Spinal Fusion; Blood loss; perioperative blood loss; intraoperative blood loss; postoperative blood loss; surgical blood loss Inclusion criteria Types of participants This review will consider studies that include patients undergoing any type of spine surgery who received intravenous TXA and all patients with comorbidities. There was no restriction on the age of the patients because the initiation and process of blood clotting and fibrinolysis does not discriminate between different age groups. There is no restriction on the age of these patients. Patients with coagulopathies or those receiving preoperative anticoagulant therapy will be excluded. Types of intervention(s)/phenomena of interest This review will consider studies that evaluate the effectiveness of intravenous TXA administration on perioperative blood loss on all patients undergoing spine surgery. The administration of TXA will be compared to either patients receiving no TXA or a placebo of saline as reported. Studies comparing TXA to other antifibrinolytics will be excluded. Types of outcomes This review will consider studies that include the following outcome measures: intraoperative and postoperative blood loss collectively referred to as perioperative blood loss. The intraoperative blood loss will be measured by weighing surgical sponges, measuring the volume of blood collected in suction Page 125
4 canisters and subtracting the irrigation fluid, and cell salvage devices and reported as estimated blood loss (EBL). Postoperative blood loss is measured from the volume of blood collected in the drainage bag or collecting reservoir. A secondary outcome to be measured will be the intravenous loading and maintenance dose of TXA administered to patients undergoing spine surgery. Types of studies This review will consider any experimental study design including randomized controlled trials, non-randomized controlled trials, quasi-experimental, before and after studies, prospective and retrospective cohort studies and case control studies for inclusion. Prior to inclusion in the review the independent reviewers will use standardized critical appraisal instruments from the Joanna Briggs Institute Meta Analysis of Statistics Assessment and Review Instrument (JBI-MAStARI) (Appendix I). Search strategy The search strategy aims to find both published and unpublished studies. A three-step search strategy will be utilized in this review. An initial limited search of MEDLINE and CINAHL will be undertaken followed by analysis of the text words contained in the title and abstract, and of the index terms used to describe article. A second search using all identified keywords and index terms will then be undertaken across all included databases. Thirdly, the reference list of all identified reports and articles will be searched for additional studies. Studies published from 1960 to March 2013 will be considered for inclusion in this review. The year 1960 was the year in which TXA was introduced and first documented in the literature. The search will be limited to English language publications. The databases to be searched include: Academic Search Complete CINAHL Cochrane Library Embase EBSCO Medline ProQuest PubMed Science Direct The search for unpublished studies will include: Google Scholar MEDNAR ProQuest Nursing and Allied Health Source ProQuest Dissertations and Theses OpenSIGLE Virginia Henderson Library Page 126
5 Initial keywords to be used will be: Tranexamic acid or Tranexamic or Cyclohexanecarboxylic Spine surgery OR Diskectomy OR Laminectomy OR Spinal Fusion Blood loss, perioperative blood loss, intraoperative blood loss, postoperative blood loss, surgical blood loss Assessment of methodological quality Papers selected for retrieval will be assessed by two independent reviewers for methodological validity prior to inclusion in the review using standardized critical appraisal instruments from the Joanna Briggs Institute Meta Analysis of Statistics Assessment and Review Instrument (JBI-MAStARI) (Appendix I). Any disagreements that arise between the reviewers will be resolved through discussion. Data collection Data will be extracted from papers included in the review will be conducted by two independent reviewers using the standardized data extraction tool from JBI-MAStARI (Appendix II). The data extracted will include specific details about the interventions, populations, study methods and outcomes of significance to the review question and specific objectives. The attempt to contact authors will be made in the event of missing data. Data synthesis Quantitative data will, where possible, be pooled in statistical meta-analysis using JBI-MAStARI. All results will be subject to double data entry. Effect sizes expressed as weighted mean differences for continuous data of perioperative blood loss and their 95% confidence intervals will be calculated for analysis. Heterogeneity will be assessed statistically using the standard Chi-square. Where statistical pooling is not possible the findings will be presented in narrative form including tables and figures to aid in data presentation where appropriate. If variance appears to exist in subgroups such as types of spine surgery, clinical heterogeneity will be explored. Conflicts of interest No conflicts of interest Acknowledgements Harris College of Nursing and Health Sciences Center for Evidence Based Practice and Research: A Collaborating Center of the Joanna Briggs Institute Page 127
6 References 1. Marketos S, Skiadas P. Hippocrates. The father of spine surgery. Spine. 1999: Knoeller SM, Seifried C. Historical Perspective History of Spine Surgery. Spine. 2000: Mervyn R. Perioperative bleeding in spinal surgery: identification and management. Pharmacological management of perioperative bleeding. CME Network.1996: Wilkey B. In L. Chu L, Fuller A. Spine Surgery. Manual of Clinical Anesthesiology.2012: Urban, MK. The Efficacy of Antifibrinolytics in the Reduction of Blood Loss During Complex Adult Reconstructive Spine Surgery. Spine.2001; 26(10): Florentino-Pineda I, Thompson GH, Poe-Kochert C, Huang RP, Haber LL, Blakemore LC. The Effect of Amicar on Perioperative Blood Loss in Idiopathic Scoliosis: The Results of a Prospective, Randomized Double-Blind Study. Spine.2004; 29(3): Farrokhi MR, Kazemi AP, Eftekharian H, Akbari K. Efficacy of Prophylactic Low Dose of Tranexamic Acid in Spinal Fixation Surgery: A Randomized Clinical Trial. J Neurosurg Anesthesiol. 2011; 23(4): Stefan E, Heinz M, Wilke A. Efficacy of tranexamic acid in reducing blood loss in posterior lumbar spine surgery for degenerative spinal stenosis with instability: a retrospective case control study. BMC Surgery. 2011;11(29). 9. Yagi M, Hasegawa J, Nagoshi N, Lizuka S. Does the Intraoperative Tranexamic Acid Decrease Operative Blood loss during posterior spinal fusion for treatment of adolescent idiopathic scoliosis. Spine.2012; 37(21): Baldus C, Bridwell K, Lenke LG, Okunadejo GO. Can we Safely Reduce Blood Loss During Lumbar Pedicle Subtraction Osteotomy Procedures Using Tranexamic Acid or Aprotinin? Spine.2010; 35(2): Fergusson DA, Hébert PC, Mazer CD, Fremes S, MacAdams C, Murkin JM, et al. A comparison of aprotinin and lysine analogues in high-risk cardiac surgery. New England Journal of Medicine. 2008; 358(22): Hardy JF, Desroches J. Natural and Synthetic antifirinolytics in cardiac surgery. Canadian Journal Anesthesiology. 1992; 39(4): Cap AP, Baer DG, Orman JA, Aden J, Ryan K, Blackbourne LH. Tranexamic acid for trauma patients: a critical review of the literature. Journal of Trauma. 2011; 71: Ong YL, Hull DR, Mayne EE. Menorrhagia in von Willebrand disease successfully treated with single daily dose tranexamic acid. Haemophilia.1998;4(1): Dunn CJ, Karen GL. Tranexamic acid: a review of its use in surgery and other indications. Drugs.1999; 57(6): Ho KM, Ismail H. Use of intravenous tranexamic acid to reduce allogeneic blood transfusion in total hip and knee arthroplasty: a meta-analysis. Anaesth Intensive Care. 2003;31: Page 128
7 17. Neilipovitz DT, Murto K, Hall L. A randomized trial of tranexamic acid to reduce blood transfusion for scoliosis surgery. Anesthesia Analog.2001;93(1): Zufferey P, Merquiol F, Laporte S, Decousus H, Mismetti P, Auboyer C, et al. Do antifibrinolutics reduce allogenic blood transfusion in orthopedic surgery? Anesthesiology.2006;105: Shapiro F, Zurakowski, D, Sethna, N. Tranexamic acid diminishes intraoperative blood loss and transfusion in spinal fusions for Duchenne muscular dystrophy scoliosis. SPINE.2007;32(20): Elwatidy S, Jamjoom Z, Turkistani A, El-Dawlatly A. Efficacy and safety of prophylactic large dose of tranexamic acid in spine surgery: a prospective, randomized, double-blind, placebo-controlled study. Spine.2008: Wong J, El Beheiry H, Rampersaund Y, Lewis S, Ahn H. Tranexamic acid reduces perioperative blood loss in adult patients having spinal fusion surgery. Anesth Analg.2008; 107: Tzortzopoulou A, Cepeda MS, Schumann R, Carr DB. Anitfibrinolytic agents for reducing blood loss in scoliosis surgery in children. Cochrane Database of Systematic Reviews. 2008;(3). 23. Gill JB, Chin Y, Levin A, Feng D. The Use of Antifibrinolytic Agents in Spine Surgery A Meta- Analysis. The Journal of Bone and Joint Surgery.2008; 90: Insert page break Page 129
8 Appendix I: Appraisal instruments MAStARI Appraisal instrument this is a test message Insert page break Page 130
9 Appendix II: Data extraction instruments MAStARI data extraction instrument Page 131
Effect of peak inspiratory pressure on the development. of postoperative pulmonary complications.
Effect of peak inspiratory pressure on the development of postoperative pulmonary complications in mechanically ventilated adult surgical patients: a systematic review protocol Chelsa Wamsley Donald Missel
More informationEffectiveness of tranexamic acid in reducing blood loss in spinal surgery: a meta-analysis
Zhang et al. BMC Musculoskeletal Disorders 2014, 15:448 RESEARCH ARTICLE Open Access Effectiveness of tranexamic acid in reducing blood loss in spinal surgery: a meta-analysis Fan Zhang 1, Kun Wang 1,
More informationIncidental Finding of Particulate Debris in Cell Salvage Bag: A Case Report
ISPUB.COM The Internet Journal of Advanced Nursing Practice Volume 14 Number 1 Incidental Finding of Particulate Debris in Cell Salvage Bag: A Case Report T G Island Citation T G Island.. The Internet
More informationThe effect of insulin therapy algorithms on blood glucose levels in patients following cardiac surgery: A systematic review protocol
The effect of insulin therapy algorithms on blood glucose levels in patients following cardiac surgery: A systematic review protocol Megan Higgs, BN, MN, PhD Candidate 1,3 Ritin Fernandez, BSc (Nursing),
More informationEfficacy of tranexamic acid in reducing allogeneic blood products in adolescent idiopathic scoliosis surgery
Sui et al. BMC Musculoskeletal Disorders (2016) 17:187 DOI 10.1186/s12891-016-1006-y RESEARCH ARTICLE Open Access Efficacy of tranexamic acid in reducing allogeneic blood products in adolescent idiopathic
More informationThe objective of this systematic review is to assess the impact of migration on the risk of developing gastric cancer.
Review title The effect of migration on gastric cancer risk: A systematic review protocol Reviewers Haejin In, MD, MBA, MPH 1 Marisa Langdon-Embry, MS 2 1 Albert Einstein College of Medicine, haejin.in@einstein.yu.edu
More informationUse of Tranexamic Acid (TXA) on reducing blood loss during scoliosis surgery in Chinese adolescents
Ng et al. Scoliosis (2015) 10:28 DOI 10.1186/s13013-015-0052-9 RESEARCH Use of Tranexamic Acid (TXA) on reducing blood loss during scoliosis surgery in Chinese adolescents Bobby K. W. Ng 1,3*, WW Chau
More informationSYSTEMATIC REVIEW PROTOCOL
Intraoperative fluid management guided by esophageal Doppler monitoring in major abdominal surgery utilizing the enhanced recovery after surgery program: a systematic review protocol Lindsay Wuellner Lisa
More informationJBI Database of Systematic Reviews & Implementation Reports 2014;12(2)
The effectiveness of reducing dietary sodium intake versus normal dietary sodium intake in patients with heart failure on reducing readmission rate: a systematic review protocol Palle Larsen 1,4 Preben
More informationPROSPERO International prospective register of systematic reviews
PROSPERO International prospective register of systematic reviews Effectiveness of progressive muscle relaxation training for adults diagnosed with schizophrenia: a systematic review protocol Carlos Melo-Dias,
More informationEffectiveness and Safety of Tranexamic Acid in Spinal Deformity Surgery
Clinical Article J Korean Neurosurg Soc 60 (1) : 75-81, 2017 https://doi.org/10.3340/jkns.2016.0505.004 pissn 2005-3711 eissn 1598-7876 Effectiveness and Safety of Tranexamic Acid in Spinal Deformity Surgery
More informationJBI Library of Systematic Reviews JBL ; 10 (58)
The effectiveness of group visits for patients with heart failure on knowledge, quality of life, self-care, and readmissions: a systematic review protocol Jason T Slyer, DNP, RN, FNP-BC, CHFN 1,2 Lucille
More informationEffectiveness and efficiency of pre-operative anaemia management with intravenous iron: A systematic review
Effectiveness and efficiency of pre-operative anaemia management with intravenous iron: A systematic review Bernd Froessler MD, FANZCA 1,2, MSc Clinical Sciences Candidate Contact: bernd.froessler@health.sa.gov.au
More informationThe effectiveness of selective thoracic fusion for treating adolescent idiopathic scoliosis: a systematic review protocol
The effectiveness of selective thoracic fusion for treating adolescent idiopathic scoliosis: a systematic review protocol Nathan Eardley-Harris 1,2 Zachary Munn 1 Peter J Cundy 2,3 Tom J Gieroba 1,2 1.
More informationParticipant views and experiences of participating in HIV research in sub-saharan Africa: a qualitative systematic review protocol
Participant views and experiences of participating in HIV research in sub-saharan Africa: a qualitative systematic review protocol Sylvia Nalubega, RN, BSc, MSc 1 Catrin Evans, RN, BSc, MA, PhD 1 1. The
More informationImplementation of Pre-operative Planning:
Implementation of Pre-operative Planning: 1-Year Results Using Patient-Specific UNiD Rods in Adult Deformity C.J. Kleck, MD 06/16/2017 Pre-operative Planning In the fields of observation chance favors
More informationStructural barriers to highly active antiretroviral therapy (HAART) adherence: a systematic review protocol
Structural barriers to highly active antiretroviral therapy (HAART) adherence: a systematic review protocol Garumma Tolu Feyissa MPH 1,5 Aderajew Nigussie MPH 2,5 Tariku Dejene Demissie MSc 3,5 Mirkuzie
More informationA comparison of treatment options for management of End Stage Kidney Disease in elderly patients: A systematic review protocol
A comparison of treatment options for management of End Stage Kidney Disease in elderly patients: A systematic review protocol Leanne Brown Master of Nursing Science (Nurse Practitioner) 1 Glenn Gardner
More informationRisk factors for incident delirium in acute medical in-patients. A systematic review
Risk factors for incident delirium in acute medical in-patients. A systematic review Reviewers Emily Cull RN, BN(Hons) 1 Bridie Kent PhD, BSc(Hons), RN 2 Dr Nicole M. Phillips DipAppSc(Nsg), BN, GDipAdvNsg(Educ),
More informationProtocol Sistematic Review
Master in Evidence-Based Practice e Metodologia della Ricerca Clinico-assistenziale Centro Studi EBN Azienda Ospedaliero - Universitaria di Bologna Policlinico S. Orsola - Malpighi Direttore del corso:
More informationA Guide To Safe Blood Transfusion Practice
A Guide To Safe Blood Transfusion Practice Marie Browett, Pavlina Sharp, Fiona Waller, Hafiz Qureshi, Malcolm Chambers (on behalf of the UHL Blood Transfusion Team) A Guide To Safe Blood Transfusion Practice
More informationMINDFULNESS-BASED INTERVENTIONS IN EPILEPSY
03 March 2016; v.1 MINDFULNESS-BASED INTERVENTIONS IN EPILEPSY AIM This review aimed to evaluate the effectiveness of mindfulness as a therapeutic intervention for people with epilepsy. METHODS Criteria
More informationAnesthetic Management of Patients Undergoing Spine Surgery
Anesthetic Management of Patients Undergoing Spine Surgery 2016 {Music} Dr. Alan Jay Schwartz: Hello. This is Alan Jay Schwartz, Editor-in-Chief of the American Society of Anesthesiologists 2016 Refresher
More informationThe effects of binaural beat technology on physiological and psychological outcomes in adults: a systematic review protocol
The effects of binaural beat technology on physiological and psychological outcomes in adults: a systematic review protocol Yi-Tzu Sun, RN, MSN 1,2,3 Huei-Chuan Sung, RN, PhD 3,4 1. PhD candidate, Institute
More informationBayer Launches Phase III Clinical Study of Trasylol in Elective Spinal Fusion Surgery
Investor News Bayer AG Investor Relations 51368 Leverkusen Germany www.investor.bayer.com Bayer Launches Phase III Clinical Study of Trasylol in Elective Spinal Fusion Surgery Study Examines Effects of
More informationComparison of Tranexamic Acid and Aminocaproic Acid in Coronary Bypass Surgery
Butler Journal of Undergraduate Research Volume 2 Article 24 2016 Comparison of Tranexamic Acid and Aminocaproic Acid in Coronary Bypass Surgery Lisa K. LeCleir Butler University, lisa.lecleir@gmail.com
More informationJBI Database of Systematic Reviews & Implementation Reports 2014;12(9)
The effectiveness of intravenous Lidocaine used to treat pain related to peripheral potassium chloride infusion in adult hospitalized patients: a systematic review protocol Chen Xiao Juan, BSN, AdvDipONO
More information2016 OPAM Mid-Year Educational Conference, sponsored by AOCOPM Thursday, March 10, 2016 C-1
Long-term Outcomes of Lumbar Fusion Among Workers Compensation Subjects : An Historical Cohort Study Trang Nguyen M.D., Ph.D. David C. Randolph M.D, M.P.H. James Talmage MD Paul Succop PhD Russell Travis
More informationSPINE An International Journal for the study of the spine Publish Ahead of Print
SPINE An International Journal for the study of the spine Publish Ahead of Print DOI : 10.1097/BRS.0000000000001304 Assessment of Intraoperative Blood Loss at Different Surgical Stages during Posterior
More informationBlood Management 2016
Blood Management 2016 2016 AAHKS Annual Meeting Orthopaedic Team Member Course Harpal S. Khanuja, MD Associate Professor Chief of Adult Reconstruction Johns Hopkins University Chair, Johns Hopkins Bayview
More informationSystemic and Topical Use of Tranexamic Acid in Spinal Surgery: A Systematic Review
284 Review Article GLOBAL SPINE JOURNAL THIEME Systemic and Topical Use of Tranexamic Acid in Spinal Surgery: A Systematic Review Sebastian F. Winter 1 Carlo Santaguida 2 Jean Wong 3 Michael G. Fehlings
More informationMaterials and Methods
Anesthesiology 2005; 102:727 32 2005 American Society of Anesthesiologists, Inc. Lippincott Williams & Wilkins, Inc. Tranexamic Acid Reduces Intraoperative Blood Loss in Pediatric Patients Undergoing Scoliosis
More informationvan Galen KPM, Engelen ET, Mauser-Bunschoten EP, van Es RJJ, Schutgens REG
Cochrane Database of Systematic Reviews Antifibrinolytic therapy for preventing oral bleeding in patients with haemophilia or Von Willebrand disease undergoing minor oral surgery or dental extractions(review)
More informationLarge trials vs observational studies in assessing benefit and harm: the example of aprotinin
Large trials vs observational studies in assessing benefit and harm: the example of aprotinin Dean A. Fergusson, MHA, PhD Senior Scientist and Associate Director, Clinical Epidemiology Program, Ottawa
More informationAlex T. Lee, Christopher R. Barnes, Shweta Jain, and Ronald Pauldine
Case Reports in Anesthesiology Volume 2016, Article ID 1630385, 4 pages http://dx.doi.org/10.1155/2016/1630385 Case Report High Dose, Prolonged Epsilon Aminocaproic Acid Infusion, and Recombinant Factor
More informationOsteoarthrosis, unspecified whether generalized or localized, lower leg. Osteoarthrosis, localized, not specified whether primary or secondary, pelvic
Page 1 Appendix TABLE E-1 Codes (and Definitions) in Humana Database Used for Study Inclusion and Exclusion of Patients Who Underwent,, or 1 to 2-Level Inclusion ICD-9-P-8154 Total knee replacement ICD-9-D-71596
More informationThe current place of tranexamic acid in the management of bleeding
Anaesthesia 2015, 70 (Suppl. 1), 50 53 Review Article doi:10.1111/anae.12910 The current place of tranexamic acid in the management of B. J. Hunt 1,2 1 Professor of Thrombosis & Haemostasis, Kings College
More informationCodes for Back and Spinal Procedures
20930 Allograft for spine surgery only; morselized 20931 Allograft for spine surgery only; structural 20936 Autograft for spine surgery only (includes harvesting the graft); local (eg, ribs, spinous process,
More informationCERVICAL PROCEDURES PHYSICIAN CODING
CERVICAL PROCEDURES PHYSICIAN CODING Anterior Cervical Discectomy with Interbody Fusion (ACDF) Anterior interbody fusion, with discectomy and decompression; cervical below C2 22551 first interspace 22552
More informationOlder persons perceptions and experiences of community palliative care: a systematic review of qualitative evidence protocol
Older persons perceptions and experiences of community palliative care: a systematic review of qualitative evidence protocol Antoinette H. Cotton Jan Maree Sayers New South Wales Centre for Evidenced Based
More informationSCIENTIFIC PROGRAMME
SCIENTIFIC PROGRAMME LEARNING OUTCOMES: SESSION 1 PRINCIPLES OF SPINAL DEFORMITY Scoliosis: Aetiology & Prognostic Factors Describe the aetiology and prognostic factors associated with o idiopathic scoliosis
More informationIs unilateral pedicle screw fixation superior than bilateral pedicle screw fixation for lumbar degenerative diseases: a meta-analysis
Lu et al. Journal of Orthopaedic Surgery and Research (2018) 13:296 https://doi.org/10.1186/s13018-018-1004-x SYSTEMATIC REVIEW Open Access Is unilateral pedicle screw fixation superior than bilateral
More informationComprehension of the common spine disorder.
Objectives Comprehension of the common spine disorder. Disc degeneration/hernia. Spinal stenosis. Common spinal deformity (Spondylolisthesis, Scoliosis). Osteoporotic fracture. Anatomy Anatomy Anatomy
More information22110 vertebral segment; cervical vertebral segment; thoracic vertebral segment; lumbar
The following codes are authorized by Palladian Health for applicable product lines. Visit palladianhealth.com to request authorization and to access guidelines. Palladian Musculoskeletal Program Codes
More informationPatient Information ACDF. Anterior Cervical Discectomy and Fusion
Patient Information ACDF Anterior Cervical Discectomy and Fusion Table of Contents Anatomy of the Spine...2-3 General Conditions of the Cervical Spine...4 5 What is an ACDF?...6 How is an ACDF performed?...7
More informationPreoperative Variables Predicting Massive Blood Loss During Surgical Management of Adolescent Idiopathic Scoliosis
Shafa Ortho J. 2014 November; 1(4): e24630. Published online 2014 November 1. DOI: 10.5812/soj.24630 Research Article Preoperative Variables Predicting Massive Blood Loss During Surgical Management of
More informationThe effects of cognitive behaviour therapy for major depression in older adults
The effects of cognitive behaviour therapy for major depression in older adults Submitted by Rasika Sirilal Jayasekara RN, BA (Sri Lanka), BScN (Hons) (Sri Lanka), PG Dip Ed (Sri Lanka), MNSc (Adelaide),
More informationManagement of Spinal Deformities in Spinal Muscular Atrophy
Management of Spinal Deformities in Spinal Muscular Atrophy CURE SMA 2016 Annual Conference 30 June 2017 Samuel R. Rosenfeld, M.D. CHOC CHILDRENS HOSPITAL UNIVERSTY of CALIFORNIA, IRVINE Chest wall deformities
More informationAntifibrinolytic drugs for acute traumatic injury(review)
Cochrane Database of Systematic Reviews Antifibrinolytic drugs for acute traumatic injury(review) KerK,RobertsI,ShakurH,CoatsTJ KerK,RobertsI,ShakurH,CoatsTJ. Antifibrinolytic drugs for acute traumatic
More informationAre Anti- Fibrinolytic Drugs the Magic Bullets for Perioperative Hemostasis?
Are Anti- Fibrinolytic Drugs the Magic Bullets for Perioperative Hemostasis? Daniela Filipescu, MD. PhD. Assoc. Prof. of Anesthesia & Intensive Care Carol Davila University Emergency Institute of Cardiovascular
More informationDepartment of Orthopaedic Surgery, Nagahama City Hospital, University of Tokushima, Japan
Cronicon OPEN ACCESS EC ORTHOPAEDICS Research Article Topical Tranexamic Acid Reduces Postoperative Blood Loss in Patients Undergoing Primary Total Hip Arthroplasty with the Atsushi Sakuragi 1, Koji Goto
More informationNotification of changes to AXA PPP Schedule of Procedures & Fees September 2017
Call our Specialist Fees Team 01892 772160 Mon-Fri 9am-1pm specialistfees@axa-ppp.co.uk We may record and monitor calls for quality assurance, training and as a record of our conversation.. Notification
More informationAnterior cervical diskectomy icd 10 procedure code
Home Anterior cervical diskectomy icd 10 procedure code Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to
More informationRole of IONM in reducing the incidence and severity in pediatric patients with AIS
Role of IONM in reducing the incidence and severity in pediatric patients with AIS Mohamed Nassef M.D PGY 2 ANESTHESIA McMaster University DEC 9, 2015 Objectives: Literature Review on neurological complications
More informationPerioperative Complications of Pedicle Subtraction Osteotomy
630 Original Article GLOBAL SPINE JOURNAL THIEME Perioperative Complications of Pedicle Subtraction Osteotomy Michael D. Daubs 1 Darrel S. Brodke 2 Prokopis Annis 2 Brandon D. Lawrence 2 1 Division of
More informationOutcomes assessed in the review
The effectiveness of mechanical compression devices in attaining hemostasis after removal of a femoral sheath following femoral artery cannulation for cardiac interventional procedures Jones T Authors'
More informationFactors predicting blood transfusion in different surgical procedures for degenerative spine disease
European Review for Medical and Pharmacological Sciences Factors predicting blood transfusion in different surgical procedures for degenerative spine disease 2012; 16: 1853-1858 M. FOSCO, M. DI FIORE*
More informationNHS England. Evidence review: Vertebral Body Tethering for Treatment of Idiopathic Scoliosis
NHS England Evidence review: Vertebral Body Tethering for Treatment of Idiopathic Scoliosis 1 NHS England Evidence review: First published: June 2018 Updated: Not applicable Prepared by: Commissioning
More informationPatient Blood Management Are you providing this? Jeannie Callum, BA, MD, FRCPC Associate Professor, University of Toronto
Patient Blood Management Are you providing this? Jeannie Callum, BA, MD, FRCPC Associate Professor, University of Toronto Disclosures Relevant relationships with commercial entities: Octapharma, CSL Behring
More informationPosterior. Lumbar Fusion. Disclaimer. Integrated web marketing. Multimedia Health Education
Posterior Lumbar Fusion Disclaimer This movie is an educational resource only and should not be used to make a decision on. All decisions about surgery must be made in conjunction with your surgeon or
More informationU.S. MARKET FOR MINIMALLY INVASIVE SPINAL IMPLANTS
U.S. MARKET FOR MINIMALLY INVASIVE SPINAL IMPLANTS idata_usmis15_rpt Published in December 2014 By idata Research Inc., 2014 idata Research Inc. Suite 308 4211 Kingsway Burnaby, British Columbia, Canada,
More informationOriginal Date: October 2015 LUMBAR SPINAL FUSION FOR
National Imaging Associates, Inc. Clinical guidelines Original Date: October 2015 LUMBAR SPINAL FUSION FOR Page 1 of 9 INSTABILITY AND DEGENERATIVE DISC CONDITIONS FOR CMS (MEDICARE) MEMBERS ONLY CPT4
More informationPatient Information. Spinal Fusion Using the ST360 or Silhouette Pedicle Screw System
Patient Information Spinal Fusion Using the ST360 or Silhouette Pedicle Screw System Spinal Fusion Using the ST360 or Silhouette Pedicle Screw System Your doctor has recommended spinal fusion surgery using
More informationJBI Database of Systematic Reviews & Implementation Reports 2013;11(9)
Effectiveness of surgical versus conservative treatment for symptomatic unilateral spondylolysis of the lumbar spine in athletes: a systematic review protocol Morné Scheepers 1 MBCHB, BHSC (physio) Manuel
More informationBECLOT 500MG. INJECTION Composition : Each ml. contains : Tranexamic Acid I.P. 100mg.
BECLOT 500MG. INJECTION Composition : Each ml. contains : Tranexamic Acid I.P. 100mg. DESCRIPTION Tranexamic acid is a synthetic analog of the amino acid lysine. It is used to treat or prevent excessive
More informationIntraoperative haemorrhage and haemostasis. Dr. med. Christian Quadri Capoclinica Anestesia, ORL
Intraoperative haemorrhage and haemostasis Dr. med. Christian Quadri Capoclinica Anestesia, ORL Haemostasis is like love. Everybody talks about it, nobody understands it. JH Levy 2000 Intraoperative Haemorrhage
More informationPediatric scoliosis. Patient and family guide to understanding
Patient and family guide to understanding Pediatric scoliosis This brochure is not meant to replace any personal conversations that the patient and family might wish to have with the physician or healthcare
More informationNATIONAL INSTITUTE FOR CLINICAL EXCELLENCE
NATIONAL INSTITUTE FOR CLINICAL EXCELLENCE INTERVENTIONAL PROCEDURES PROGRAMME Interventional procedures overview of direct C1 lateral mass screw procedure for cervical spine stabilisation Introduction
More informationTITLE: Acetylsalicylic Acid for Venous Thromboembolism Prophylaxis: A Review of Clinical Evidence, Benefits and Harms
TITLE: Acetylsalicylic Acid for Venous Thromboembolism Prophylaxis: A Review of Clinical Evidence, Benefits and Harms DATE: 23 August 2011 CONTEXT AND POLICY ISSUES: Thromboembolism occurs when a blood
More informationA Systematic Review and Meta-Analysis of Pre-Transfusion Hemoglobin Thresholds for Allogeneic Red Blood Cell Transfusions
A Systematic Review and Meta-Analysis of Pre-Transfusion Hemoglobin Thresholds for Allogeneic Red Blood Cell Transfusions Authors: Lesley J.J. Soril 1,2, MSc; Laura E. Leggett 1,2, MSc; Joseph Ahn, MSc
More informationObjectives. Comprehension of the common spine disorder
Objectives Comprehension of the common spine disorder Disc degeneration/hernia Spinal stenosis Common spinal deformity (Spondylolisthesis, Scoliosis) Osteoporotic fracture Destructive spinal lesions Anatomy
More informationSpine Center. at Stamford Hospital s Orthopedic Institute
Spine Center at Stamford Hospital s Orthopedic Institute Back pain related to spinal deformity and injury or congenital conditions is a common health complaint, which can be very debilitating. At Stamford
More informationLIMB COMPRESSION DEVICES FOR VENOUS THROMBOEMBOLISM PROPHYLAXIS
PROPHYLAXIS Non-Discrimination Statement and Multi-Language Interpreter Services information are located at the end of this document. Coverage for services, procedures, medical devices and drugs are dependent
More informationUANL UNIVERSIDAD AUTÓNMA DE NUEVO LEÓN
First comparative study of the effectiveness of the use of Tranexamic Acid against!- Aminocapróic Acid in multiple doses via the oral route for the reduction of post-operative bleeding and transfusion
More informationClinical Practice Guideline for Patients Requiring Total Hip Replacement
Clinical Practice Guideline for Patients Requiring Total Hip Replacement Inclusions Patients undergoing elective total hip replacement Exclusions Patients with active local or systemic infection or medical
More informationInt J Clin Exp Med 2018;11(2): /ISSN: /IJCEM Yi Yang, Hao Liu, Yueming Song, Tao Li
Int J Clin Exp Med 2018;11(2):1278-1284 www.ijcem.com /ISSN:1940-5901/IJCEM0063093 Case Report Dislocation and screws pull-out after application of an Isobar TTL dynamic stabilisation system at L2/3 in
More informationThe effectiveness of peer support interventions for community-dwelling adults with chronic non-cancer pain: a systematic review protocol
The effectiveness of peer support interventions for community-dwelling adults with chronic non-cancer pain: a systematic review protocol Kay Cooper, PhD, MSc, BSc 1 Sylvia Wilcock, PhD 1 1. The Scottish
More informationPART III IN HOSPITAL ON CALL ANESTHESIA COVERAGE
Anesthesia g) A consultation may not be claimed where the patient is referred to the anesthetist for the sole purpose of providing post-operative Patient Controlled Analgesia. h) Tariff 8406 may not be
More informationIntraarticular vs Intravenous Tranexamic Acid in Reduction of Blood Loss in Primary Total Knee Replacement
Arunkumar Vijay et al ORIGINAL RESEARCH 10.5005/jp-journals-10028-1195 Intraarticular vs Intravenous Tranexamic Acid in Reduction of Blood Loss in Primary Total Knee Replacement 1 Arunkumar Vijay, 2 Jambu
More informationAnesthesia for Total Hip and Knee Arthroplasty
Anesthesia for Total Hip and Knee Arthroplasty Typical approach Describe anesthesia technique Rather Describe issues with THA and TKA How anesthesia can modify Issues Total Hip Total Knee Blood Loss ++
More informationThe effectiveness of trace element supplementation following severe burn injury: A systematic review protocol
The effectiveness of trace element supplementation following severe burn injury: A systematic review protocol Rochelle Kurmis BND APD, CF JBI 1,2 Edoardo Aromataris BSc(Hons), PhD 1 John Greenwood AM,
More informationPOSTERIOR CERVICAL FUSION
AN INTRODUCTION TO PCF POSTERIOR CERVICAL FUSION This booklet provides general information on the Posterior Cervical Fusion (PCF) surgical procedure for you to discuss with your physician. It is not meant
More informationThe Effects of Macronutrient Intake on the Risk of Developing Type 2 Diabetes: A Systematic Review
Review Title The Effects of Macronutrient Intake on the Risk of Developing Type 2 Diabetes: A Systematic Review Centre Conducting Review The University of Newcastle Evidence Based Health Care Group: Joanna
More informationSurgical Neurology International
Surgical Neurology International SNI: Spine, a supplement to Surgical Neurology International OPEN ACCESS For entire Editorial Board visit : http://www.surgicalneurologyint.com Editor: Nancy E. Epstein,
More informationSimultaneous anterior vertebral column resection-distraction and posterior rod contouring for restoration of sagittal balance: report of a technique
Case Report Simultaneous anterior vertebral column resection-distraction and posterior rod contouring for restoration of sagittal balance: report of a technique Shaishav Bhagat 1, Alexander Z. E. Durst
More informationIndex. Note: Page numbers of article titles are in boldface type.
Orthop Clin N Am 38 (2007) 463 468 Index Note: Page numbers of article titles are in boldface type. A Andreas Vesalius, in history of spine pathology, 306 Anesthesia/anesthetics for PECD, 329 in minimally
More informationDeep vein thrombosis and its prevention in critically ill adults Attia J, Ray J G, Cook D J, Douketis J, Ginsberg J S, Geerts W H
Deep vein thrombosis and its prevention in critically ill adults Attia J, Ray J G, Cook D J, Douketis J, Ginsberg J S, Geerts W H Authors' objectives To systematically review the incidence of deep vein
More informationThe effect of body mass index on lumbar lordosis on the Mizuho OSI Jackson spinal table
35 35 40 The effect of body mass index on lumbar lordosis on the Mizuho OSI Jackson spinal table Authors Justin Bundy, Tommy Hernandez, Haitao Zhou, Norman Chutkan Institution Orthopaedic Department, Medical
More informationIntra-operative neurologic injuries: Avoidance and prompt response
Intra-operative neurologic injuries: Avoidance and prompt response James S. Harrop MD, FACS Professor Neurological and Orthopedic Surgery Director, Division of Spine and Peripheral Nerve Surgery Nsurg
More informationSystematic review and meta-analysis of the use of tranexamic acid in total hip replacement
Systematic review and meta-analysis of the use of tranexamic acid in total hip replacement M. Sukeik, S. Alshryda, F. S. Haddad, J. M. Mason From University College London Hospital, London, United Kingdom
More informationPatient Information MIS LLIF. Lateral Lumbar Interbody Fusion Using Minimally Invasive Surgical Techniques
Patient Information MIS LLIF Lateral Lumbar Interbody Fusion Using Minimally Invasive Surgical Techniques Table of Contents Anatomy of Spine....2 General Conditions of the Spine....4 What is Spondylolisthesis....5
More informationIntraoperative case studies. Portable full body 32-slice CT scanner
Intraoperative case studies Portable full body 32-slice CT scanner Point-of-care CT imaging Your multi-departmental imaging solution Orthopedic surgery Arthroplasty Musculoskeletal disorders Hip replacement
More informationThe efficacy and safety of topical administration of tranexamic acid in spine surgery: a meta-analysis
Luo et al. Journal of Orthopaedic Surgery and Research (2018) 13:96 https://doi.org/10.1186/s13018-018-0815-0 RESEARCH ARTICLE The efficacy and safety of topical administration of tranexamic acid in spine
More informationESCOME Pre-Course Outline (v1.09)
ESCOME Pre-Course Outline (v1.09) 1. Basics of Spinal Disorders Introduction to Spinal Surgery Spinal Anatomy Introduction to Vertebral Anatomical Concepts Anatomy and Function of Joints and Ligaments
More informationPROSPERO International prospective register of systematic reviews
PROSPERO International prospective register of systematic reviews Closed reduction methods for acute anterior shoulder dislocation [Cochrane Protocol] Kanthan Theivendran, Raj Thakrar, Subodh Deshmukh,
More informationIncidence of deep vein thrombosis after major spine surgeries with no mechanical or chemical prophylaxis
29 29 33 Incidence of deep vein thrombosis after major spine surgeries with no mechanical or chemical prophylaxis Author Institution Sreedharan Namboothiri Kovai Medical Center and Hospitals, Coimbatore,
More informationEffects of dexamethasone on sugammadex reversal times of rocuronium: a systematic review protocol
Effects of dexamethasone on sugammadex reversal times of rocuronium: a systematic review protocol Cassie R. Held Mackenzie D. Sullivan The Center for Translational Research: a Joanna Briggs Institute Center
More informationSpinal deformities, such as increased thoracic
An Original Study Clinical and Radiographic Evaluation of Sagittal Imbalance: A New Radiographic Assessment Hossein Elgafy, MD, MCh, FRCS Ed, FRCSC, Rick Bransford, MD, Hassan Semaan, MD, and Theodore
More informationACDF. Anterior Cervical Discectomy and Fusion. An introduction to
An introduction to ACDF Anterior Cervical Discectomy and Fusion This booklet provides general information on ACDF. It is not meant to replace any personal conversations that you might wish to have with
More informationBlood Conservation Techniques
Blood Conservation Techniques Dolores B. Njoku, MD Assistant Professor Johns Hopkins Medical Institutions Baltimore, MD Objective: Upon completion of the lecture, the participant will be aware of a range
More information