2018 AANS Annual Scientific Meeting-Scientific Session IV: Pediatrics, Question and Answer Session IV

Video Transcription

Do we have some time for questions?  How many patients played transfusions altogether? How many patients? In this study, just a couple. Some of the interesting things, I didn't have time to go over in six minutes.  What we saw in both studies is that, as you might expect from a clot stabilizer, there was really no post-operative blood transfusions,  which was markedly different in the area from when there was the placebo group. So the drain outputs were much lower, and nobody got blood after.  The average exposure, if we look at our first study, the patients that got placebo were being exposed to three units of blood,  and the patients that got TXA were getting exposed to one unit of blood. So there's a marked reduction.  I can say, well maybe I shouldn't say, but I just reviewed a manuscript as I was flying here. There are centers now that are really achieving no transfusions with the use of TXA.  So I think it is possible, and I would say even in this study, our rates of blood loss were half of what they were in the TXA groups in our study six years ago.  So I think surgical and anesthetic technique is really making a difference. We have not achieved no blood exposure at our institution, but other institutions are doing it now.  Are you aware of any adult studies to reduce the dose of TXA as well? I'm not personally aware of it, but there may well be.  Are you using this outside of your craniofacial cases now?  I'd say it's sort of standardized in the craniofacial cases, but we are using it in a lot of brain tumor cases.  If it's thought it's going to be a bloody brain tumor, it's given pretty routinely. We haven't studied that, but it's definitely become somewhat standard of care.  It's standard of care in the cardiac cases at our institution, or at least certain ones of them.  The first study out of our institution was in spine cases, so we use it fairly routinely because we think it seems to be very safe and very effective.

Video Summary

In this video, the presenter discusses the use of tranexamic acid (TXA) in reducing blood transfusions post-surgery. The presenter mentions that in two studies, TXA acted as a clot stabilizer, resulting in no post-operative blood transfusions, unlike the placebo group. The study showed that patients who received TXA were exposed to fewer units of blood compared to those who received a placebo. The presenter also mentions that some centers have achieved no transfusions with the use of TXA. TXA is commonly used in craniofacial cases and brain tumor cases that are expected to be bloody. It has become standard of care in cardiac and spine cases due to its safety and effectiveness. The presenter suggests that surgical and anesthetic techniques play a significant role in reducing blood loss.

Asset Caption

Scientific Session IV: Pediatrics, Question and Answer Session IV

Keywords

tranexamic acid

blood transfusions

clot stabilizer

post-operative

placebo group