A Comparative Study Between Tranexamic Acid (TXA) and Fibrinongen Concentrate in Bleeding Control of Total Hip Arthroplasty (THA)

Jehan Mohammad Ezzat Hamed; Rabab Mohamed Mohamed

doi:doi:10.11648/j.ijacm.20221001.13

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A Comparative Study Between Tranexamic Acid (TXA) and Fibrinongen Concentrate in Bleeding Control of Total Hip Arthroplasty (THA)

Jehan Mohammad Ezzat Hamed, Rabab Mohamed Mohamed

Published in International Journal of Anesthesia and Clinical Medicine (Volume 10, Issue 1)

Received: 23 March 2022 Accepted: 9 April 2022 Published: 14 April 2022

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Abstract

Total hip arthroplasty (THA) faces the hazard of surgical blood loss and significant invisible blood loss due to bleeding into tissue and hemolysis. Tranexamic acid (TXA) and fibrinogen are important agents among a diversity of intraoperative blood management protocols. During the coagulation cascade, thrombin enhances fibrinogen and hastens fibrin polymerization forming an intense network important in clot formation. Our study included sixty male patients that were randomized into two groups; patients receiving 15 mg/kg TXA given as a single slow intravenous bolus injection 15 minutes before incision were placed in (group 1). Patients receiving 30 mg/kg fibrinogen concentrate administered post induction of general anesthesia were placed in (group 2). Intraoperative (IO) mean heart rate (HR) and mean arterial pressure (MAP) showed no significant differences. There was a significant decrease in IO blood loss in fibrinogen (723.03. ± 117.69) group compared to TXA (879.30 ± 168.54) (p=0.001), with significant (P=0.010) differences in the amount of transfused packed RBCs (IQR:1-2). Field visibility also improved significantly (p=0. 017) in fibrinogen group. The amounts of Lactated Ringer’s (LR) solution infused during surgery were not significantly different while a significant (p=0.037) decrease in the additional amount of hydroxyethyl starch (HES) solution infused in patients with fibrinogen (211.87 ± 32.30) over TXA (250.63 ± 43.65) was noted. In conclusion, administration of fibrinogen concentrate before procedure in patients undergoing THA reduces blood loss. Consequently, this therapeutic process has the potential to change the treatment model for perioperative hemorrhage in patients with potentially life-threatening coagulopathy.

Published in	International Journal of Anesthesia and Clinical Medicine (Volume 10, Issue 1)
DOI	10.11648/j.ijacm.20221001.13
Page(s)	16-23
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2022. Published by Science Publishing Group

Keywords

Tranexamic Acid, Fibrinogen Concentrate, Total Hip Arthroplasty, General Anesthesia

References

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APA Style

Jehan Mohammad Ezzat Hamed, Rabab Mohamed Mohamed. (2022). A Comparative Study Between Tranexamic Acid (TXA) and Fibrinongen Concentrate in Bleeding Control of Total Hip Arthroplasty (THA). International Journal of Anesthesia and Clinical Medicine, 10(1), 16-23. https://doi.org/10.11648/j.ijacm.20221001.13

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Jehan Mohammad Ezzat Hamed; Rabab Mohamed Mohamed. A Comparative Study Between Tranexamic Acid (TXA) and Fibrinongen Concentrate in Bleeding Control of Total Hip Arthroplasty (THA). Int. J. Anesth. Clin. Med. 2022, 10(1), 16-23. doi: 10.11648/j.ijacm.20221001.13

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AMA Style

Jehan Mohammad Ezzat Hamed, Rabab Mohamed Mohamed. A Comparative Study Between Tranexamic Acid (TXA) and Fibrinongen Concentrate in Bleeding Control of Total Hip Arthroplasty (THA). Int J Anesth Clin Med. 2022;10(1):16-23. doi: 10.11648/j.ijacm.20221001.13

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@article{10.11648/j.ijacm.20221001.13,
  author = {Jehan Mohammad Ezzat Hamed and Rabab Mohamed Mohamed},
  title = {A Comparative Study Between Tranexamic Acid (TXA) and Fibrinongen Concentrate in Bleeding Control of Total Hip Arthroplasty (THA)},
  journal = {International Journal of Anesthesia and Clinical Medicine},
  volume = {10},
  number = {1},
  pages = {16-23},
  doi = {10.11648/j.ijacm.20221001.13},
  url = {https://doi.org/10.11648/j.ijacm.20221001.13},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijacm.20221001.13},
  abstract = {Total hip arthroplasty (THA) faces the hazard of surgical blood loss and significant invisible blood loss due to bleeding into tissue and hemolysis. Tranexamic acid (TXA) and fibrinogen are important agents among a diversity of intraoperative blood management protocols. During the coagulation cascade, thrombin enhances fibrinogen and hastens fibrin polymerization forming an intense network important in clot formation. Our study included sixty male patients that were randomized into two groups; patients receiving 15 mg/kg TXA given as a single slow intravenous bolus injection 15 minutes before incision were placed in (group 1). Patients receiving 30 mg/kg fibrinogen concentrate administered post induction of general anesthesia were placed in (group 2). Intraoperative (IO) mean heart rate (HR) and mean arterial pressure (MAP) showed no significant differences. There was a significant decrease in IO blood loss in fibrinogen (723.03. ± 117.69) group compared to TXA (879.30 ± 168.54) (p=0.001), with significant (P=0.010) differences in the amount of transfused packed RBCs (IQR:1-2). Field visibility also improved significantly (p=0. 017) in fibrinogen group. The amounts of Lactated Ringer’s (LR) solution infused during surgery were not significantly different while a significant (p=0.037) decrease in the additional amount of hydroxyethyl starch (HES) solution infused in patients with fibrinogen (211.87 ± 32.30) over TXA (250.63 ± 43.65) was noted. In conclusion, administration of fibrinogen concentrate before procedure in patients undergoing THA reduces blood loss. Consequently, this therapeutic process has the potential to change the treatment model for perioperative hemorrhage in patients with potentially life-threatening coagulopathy.},
 year = {2022}
}

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TY  - JOUR
T1  - A Comparative Study Between Tranexamic Acid (TXA) and Fibrinongen Concentrate in Bleeding Control of Total Hip Arthroplasty (THA)
AU  - Jehan Mohammad Ezzat Hamed
AU  - Rabab Mohamed Mohamed
Y1  - 2022/04/14
PY  - 2022
N1  - https://doi.org/10.11648/j.ijacm.20221001.13
DO  - 10.11648/j.ijacm.20221001.13
T2  - International Journal of Anesthesia and Clinical Medicine
JF  - International Journal of Anesthesia and Clinical Medicine
JO  - International Journal of Anesthesia and Clinical Medicine
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EP  - 23
PB  - Science Publishing Group
SN  - 2997-2698
UR  - https://doi.org/10.11648/j.ijacm.20221001.13
AB  - Total hip arthroplasty (THA) faces the hazard of surgical blood loss and significant invisible blood loss due to bleeding into tissue and hemolysis. Tranexamic acid (TXA) and fibrinogen are important agents among a diversity of intraoperative blood management protocols. During the coagulation cascade, thrombin enhances fibrinogen and hastens fibrin polymerization forming an intense network important in clot formation. Our study included sixty male patients that were randomized into two groups; patients receiving 15 mg/kg TXA given as a single slow intravenous bolus injection 15 minutes before incision were placed in (group 1). Patients receiving 30 mg/kg fibrinogen concentrate administered post induction of general anesthesia were placed in (group 2). Intraoperative (IO) mean heart rate (HR) and mean arterial pressure (MAP) showed no significant differences. There was a significant decrease in IO blood loss in fibrinogen (723.03. ± 117.69) group compared to TXA (879.30 ± 168.54) (p=0.001), with significant (P=0.010) differences in the amount of transfused packed RBCs (IQR:1-2). Field visibility also improved significantly (p=0. 017) in fibrinogen group. The amounts of Lactated Ringer’s (LR) solution infused during surgery were not significantly different while a significant (p=0.037) decrease in the additional amount of hydroxyethyl starch (HES) solution infused in patients with fibrinogen (211.87 ± 32.30) over TXA (250.63 ± 43.65) was noted. In conclusion, administration of fibrinogen concentrate before procedure in patients undergoing THA reduces blood loss. Consequently, this therapeutic process has the potential to change the treatment model for perioperative hemorrhage in patients with potentially life-threatening coagulopathy.
VL  - 10
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Author Information

Jehan Mohammad Ezzat Hamed

Faculty of Medicine, Tanta University, Tanta, Egypt
Rabab Mohamed Mohamed

Faculty of Medicine, Tanta University, Tanta, Egypt

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Jehan Mohammad Ezzat Hamed, Rabab Mohamed Mohamed. (2022). A Comparative Study Between Tranexamic Acid (TXA) and Fibrinongen Concentrate in Bleeding Control of Total Hip Arthroplasty (THA). International Journal of Anesthesia and Clinical Medicine, 10(1), 16-23. https://doi.org/10.11648/j.ijacm.20221001.13

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ACS Style

Jehan Mohammad Ezzat Hamed; Rabab Mohamed Mohamed. A Comparative Study Between Tranexamic Acid (TXA) and Fibrinongen Concentrate in Bleeding Control of Total Hip Arthroplasty (THA). Int. J. Anesth. Clin. Med. 2022, 10(1), 16-23. doi: 10.11648/j.ijacm.20221001.13

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AMA Style

Jehan Mohammad Ezzat Hamed, Rabab Mohamed Mohamed. A Comparative Study Between Tranexamic Acid (TXA) and Fibrinongen Concentrate in Bleeding Control of Total Hip Arthroplasty (THA). Int J Anesth Clin Med. 2022;10(1):16-23. doi: 10.11648/j.ijacm.20221001.13

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@article{10.11648/j.ijacm.20221001.13,
  author = {Jehan Mohammad Ezzat Hamed and Rabab Mohamed Mohamed},
  title = {A Comparative Study Between Tranexamic Acid (TXA) and Fibrinongen Concentrate in Bleeding Control of Total Hip Arthroplasty (THA)},
  journal = {International Journal of Anesthesia and Clinical Medicine},
  volume = {10},
  number = {1},
  pages = {16-23},
  doi = {10.11648/j.ijacm.20221001.13},
  url = {https://doi.org/10.11648/j.ijacm.20221001.13},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijacm.20221001.13},
  abstract = {Total hip arthroplasty (THA) faces the hazard of surgical blood loss and significant invisible blood loss due to bleeding into tissue and hemolysis. Tranexamic acid (TXA) and fibrinogen are important agents among a diversity of intraoperative blood management protocols. During the coagulation cascade, thrombin enhances fibrinogen and hastens fibrin polymerization forming an intense network important in clot formation. Our study included sixty male patients that were randomized into two groups; patients receiving 15 mg/kg TXA given as a single slow intravenous bolus injection 15 minutes before incision were placed in (group 1). Patients receiving 30 mg/kg fibrinogen concentrate administered post induction of general anesthesia were placed in (group 2). Intraoperative (IO) mean heart rate (HR) and mean arterial pressure (MAP) showed no significant differences. There was a significant decrease in IO blood loss in fibrinogen (723.03. ± 117.69) group compared to TXA (879.30 ± 168.54) (p=0.001), with significant (P=0.010) differences in the amount of transfused packed RBCs (IQR:1-2). Field visibility also improved significantly (p=0. 017) in fibrinogen group. The amounts of Lactated Ringer’s (LR) solution infused during surgery were not significantly different while a significant (p=0.037) decrease in the additional amount of hydroxyethyl starch (HES) solution infused in patients with fibrinogen (211.87 ± 32.30) over TXA (250.63 ± 43.65) was noted. In conclusion, administration of fibrinogen concentrate before procedure in patients undergoing THA reduces blood loss. Consequently, this therapeutic process has the potential to change the treatment model for perioperative hemorrhage in patients with potentially life-threatening coagulopathy.},
 year = {2022}
}

Copy | Download

TY  - JOUR
T1  - A Comparative Study Between Tranexamic Acid (TXA) and Fibrinongen Concentrate in Bleeding Control of Total Hip Arthroplasty (THA)
AU  - Jehan Mohammad Ezzat Hamed
AU  - Rabab Mohamed Mohamed
Y1  - 2022/04/14
PY  - 2022
N1  - https://doi.org/10.11648/j.ijacm.20221001.13
DO  - 10.11648/j.ijacm.20221001.13
T2  - International Journal of Anesthesia and Clinical Medicine
JF  - International Journal of Anesthesia and Clinical Medicine
JO  - International Journal of Anesthesia and Clinical Medicine
SP  - 16
EP  - 23
PB  - Science Publishing Group
SN  - 2997-2698
UR  - https://doi.org/10.11648/j.ijacm.20221001.13
AB  - Total hip arthroplasty (THA) faces the hazard of surgical blood loss and significant invisible blood loss due to bleeding into tissue and hemolysis. Tranexamic acid (TXA) and fibrinogen are important agents among a diversity of intraoperative blood management protocols. During the coagulation cascade, thrombin enhances fibrinogen and hastens fibrin polymerization forming an intense network important in clot formation. Our study included sixty male patients that were randomized into two groups; patients receiving 15 mg/kg TXA given as a single slow intravenous bolus injection 15 minutes before incision were placed in (group 1). Patients receiving 30 mg/kg fibrinogen concentrate administered post induction of general anesthesia were placed in (group 2). Intraoperative (IO) mean heart rate (HR) and mean arterial pressure (MAP) showed no significant differences. There was a significant decrease in IO blood loss in fibrinogen (723.03. ± 117.69) group compared to TXA (879.30 ± 168.54) (p=0.001), with significant (P=0.010) differences in the amount of transfused packed RBCs (IQR:1-2). Field visibility also improved significantly (p=0. 017) in fibrinogen group. The amounts of Lactated Ringer’s (LR) solution infused during surgery were not significantly different while a significant (p=0.037) decrease in the additional amount of hydroxyethyl starch (HES) solution infused in patients with fibrinogen (211.87 ± 32.30) over TXA (250.63 ± 43.65) was noted. In conclusion, administration of fibrinogen concentrate before procedure in patients undergoing THA reduces blood loss. Consequently, this therapeutic process has the potential to change the treatment model for perioperative hemorrhage in patients with potentially life-threatening coagulopathy.
VL  - 10
IS  - 1
ER  -

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