title: Reduction of blood loss in primary hip arthroplasty with tranexamic acid or fibrin spray.
abstract: OBJECTIVE
  Previous studies have shown that either fibrin spray or tranexamic acid can reduce blood loss at total hip replacement, but the 2 treatments have not been directly compared. We therefore conducted a randomized, controlled trial.
  
  
  METHODS
  In this randomized controlled trial we compared the effect of tranexamic acid and fibrin spray on blood loss in cemented total hip arthroplasty. 66 patients were randomized to 1 of 3 parallel groups receiving (1) a 10 mg/kg bolus of tranexamic acid prior to surgery, (2) 10 mL of fibrin spray during surgery, or (3) neither. All participants except the surgeon were blinded as to treatment group until data analysis was complete. Blood loss was calculated from preoperative and postoperative hematocrit.
  
  
  RESULTS
  Neither active treatment was found to be superior to the other in terms of overall blood loss. Losses were lower than those in the control group, when using either tranexamic acid (22% lower, p = 0.02) or fibrin spray (32% lower, p = 0.02).
  
  
  CONCLUSIONS
  We found that the use of tranexamic acid at induction, or topical fibrin spray intraoperatively, reduced blood loss compared to the control group. Blood loss was similar in the fibrin spray group and in the tranexamic acid group. ClinicalTrials.gov identifier: NCT00378872. EudraCT identifier: 2006-001299-19. Regional Ethics Committee approval: 06/S0703/55, granted June 6, 2006.
authors: Royal National Orthopaedic Hospital, Stanmore, Middlesex, UK. jsm@doctors.net.uk
authors: Jamie S
authors: JS
authors: McConnell
authors: Sandeep
authors: S
authors: Shewale
authors: Niall A
authors: NA
authors: Munro
authors: Kalpesh
authors: K
authors: Shah
authors: Angela H
authors: AH
authors: Deakin
authors: Andrew W G
authors: AW
authors: Kinninmonth
mesh_terms: D000287:Administration, Topical; D000328:Adult; D000933:Antifibrinolytic Agents / Q000008:administration & dosage*; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects / Q000379:methods; D016063:Blood Loss, Surgical / Q000517:prevention & control; D005260:Female; D015718:Fibrin Tissue Adhesive / Q000008:administration & dosage*; D006400:Hematocrit; D006490:Hemostatics / Q000008:administration & dosage*; D006801:Humans; D008297:Male; D011446:Prospective Studies; D016037:Single-Blind Method; D014148:Tranexamic Acid / Q000008:administration & dosage*; D016896:Treatment Outcome
chemical_list: D000933:Antifibrinolytic Agents; D015718:Fibrin Tissue Adhesive; D006490:Hemostatics; D014148:Tranexamic Acid