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European Spine Journal

Erschienen in:

09.02.2019 | Review Article

Antifibrinolytic agents for paediatric scoliosis surgery: a systematic review and meta-analysis

verfasst von: Shoahaib Karimi, Victor M. Lu, Mithun Nambiar, Kevin Phan, Anuruthran Ambikaipalan, Ralph J. Mobbs

Erschienen in: European Spine Journal | Ausgabe 5/2019

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Abstract

Study design

Systematic review and meta-analysis of randomised controlled trials.

Objective

The purpose of this study is to perform a systematic review and meta-analysis of antifibrinolytic agents for paediatric spine surgery.

Background

Bleeding is an important consideration in paediatric scoliosis surgery; blood loss leads directly to higher morbidity and mortality. Antifibrinolytics are an attractive non-invasive method of reducing bleeding as evidenced in arthroplasty, cardiac surgery and adult scoliosis surgery.

Methods

A thorough database search of Medline, PubMed, EMBASE and Cochrane was performed according to PRISMA guidelines, and a systematic review was performed.

Results

Five randomised controlled trials were identified in this meta-analysis, consisting of a total of 285 spine surgery patients with subgroups of tranexamic acid (n = 101), epsilon aminocaproic acid (n = 61) and control (n = 123). This meta-analysis found that antifibrinolytics lead to statistically significant reductions in peri-operative blood loss (MD − 379.16, 95% CI [− 579.76, − 178.57], p < 0.001), intra-operative blood loss (MD − 516.42, 95% CI [− 1055.58, 22.74], p < 0.001), reduced fresh frozen plasma requirements (MD − 307.77, 95% CI [− 369.66, − 245.88], p < 0.001) and reduced post-operative blood loss (MD − 185.95, 95% CI [− 336.04, − 35.87], p = 0.02).

Conclusion

This meta-analysis concludes that antifibrinolytics lead to statistically significant reductions in peri-operative blood loss, intra-operative blood loss, reduced fresh frozen plasma requirements and reduced post-operative blood loss with TXA.

Graphical abstract

These slides can be retrieved under Electronic Supplementary Material.

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Titel: Antifibrinolytic agents for paediatric scoliosis surgery: a systematic review and meta-analysis
verfasst von: Shoahaib Karimi
Victor M. Lu
Mithun Nambiar
Kevin Phan
Anuruthran Ambikaipalan
Ralph J. Mobbs
Publikationsdatum: 09.02.2019
Verlag: Springer Berlin Heidelberg
Erschienen in: European Spine Journal / Ausgabe 5/2019
Print ISSN: 0940-6719
Elektronische ISSN: 1432-0932
DOI: https://doi.org/10.1007/s00586-019-05911-8

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Abstract

Study design

Objective

Background

Methods

Results

Conclusion

Graphical abstract

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