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2016 | OriginalPaper | Buchkapitel

3. Antifibrinolytika–Tranexamsäure und Aprotinin

verfasst von : Prof. (em.) Dr. med. Guenter Singbartl, Assoc. Prof., MD Kai Singbartl, Ao. Prof. Dr. med. Hannes Todt, Dr. med. Ehrenfried Schindler, Priv.-Doz. Dr. med. Klaus Martin, Prof. Dr. Peter Peter Tassani-Prell

Erschienen in: Transfusionsassoziierte Pharmakotherapie

Verlag: Springer Berlin Heidelberg

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Zusammenfassung

Tranexamsäure (TXA) gewinnt mit zunehmend restriktiverer Transfusionsindikation an Bedeutung. Die randomisierte CRASH-2-Studie an > 20.000 Traumapatienten zeigt eine Reduktion der Mortalität um absolute 1,5% infolge Senkung der blutungsbedingten Letalität; die Letalitätsrate sonstiger Ursachen bleibt unverändert. Wichtig ist eine frühzeitige TXA-Gabe binnen 1 h n. d. Trauma. Meta-Analysen über verschiedene operative Fachgebiete hinweg belegen eine Minderung von Blutverlust/Transfusionsbedarf um relative 30–40%. Topische (Orthopädie) und i.-v.-Gabe erweisen sich als gleich wirksam.

Daten von TXA bei pädiatrischen/juvenilen Patienten sind spärlich. Die Ergebnisse deuten auf eine Minderung von Blutverlust und/oder Transfusionsbedarf hin. Der Einsatz von TXA in der Kindertraumatologie wird aus den Daten der CRASH-2-Studie abgeleitet.

Eingeschränkte Nierenfunktion bedingt abhängig vom Kreatinin-Wert eine Dosisreduktion; eingeschränkte Leberfunktion bedarf keiner Dosisanpassung.

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Titel: Antifibrinolytika–Tranexamsäure und Aprotinin
verfasst von: Prof. (em.) Dr. med. Guenter Singbartl
Assoc. Prof., MD Kai Singbartl
Ao. Prof. Dr. med. Hannes Todt
Dr. med. Ehrenfried Schindler
Priv.-Doz. Dr. med. Klaus Martin
Prof. Dr. Peter Peter Tassani-Prell
Verlag: Springer Berlin Heidelberg
Buch: Transfusionsassoziierte Pharmakotherapie
Print ISBN: 978-3-662-47257-6

Electronic ISBN: 978-3-662-47258-3

Copyright-Jahr: 2016
DOI: https://doi.org/10.1007/978-3-662-47258-3_3

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Springer Medizin

3. Antifibrinolytika–Tranexamsäure und Aprotinin

Zusammenfassung

Neu im Fachgebiet AINS

Bei schweren Reaktionen auf Insektenstiche empfiehlt sich eine spezifische Immuntherapie

Hinter dieser Appendizitis steckte ein Erreger

Ärztliche Empathie hilft gegen Rückenschmerzen

Mehr Schaden als Nutzen durch präoperatives Aussetzen von GLP-1-Agonisten?

Update AINS

Springer Medizin

Zusammenfassung

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Neu im Fachgebiet AINS

Bei schweren Reaktionen auf Insektenstiche empfiehlt sich eine spezifische Immuntherapie

Hinter dieser Appendizitis steckte ein Erreger

Ärztliche Empathie hilft gegen Rückenschmerzen

Mehr Schaden als Nutzen durch präoperatives Aussetzen von GLP-1-Agonisten?

Update AINS