title: Can topical application of tranexamic acid reduce blood loss in thoracic surgery? A prospective randomised double blind investigation.
abstract: OBJECTIVE
  The systemic or topical use of antifibrinolytic agents is effective in reducing postoperative bleeding and blood product transfusion in cardiac surgery. We sought to study the effect of the topical application of tranexamic acid into the pleural space to reduce postoperative bleeding after lung surgery.
  
  
  METHODS
  This was a prospective randomised double blind placebo controlled investigation. From May-2010 to February-2012, 89-patients, scheduled for pulmonary resection, were randomly allocated to one of the two study groups. Group-A received 5 g of tranexamic-acid in 100 ml of saline solution. Group-B received 100 ml of saline solution as placebo.
  
  
  RESULTS
  The blood loss in the first 12-h was significantly less in group-A. The same trend was observed in the first 24-h but without reaching a true statistical significance. The mean volume of blood transfusion was statistically lower in group-A. The analysis between post-operative haemoglobin concentration, haematocrit, platelet-count, international-normalised-ratio, fibrinogen and partial-thromboplastin-time of both groups was not statistically significant.
  
  
  CONCLUSIONS
  In our experience, the topical use of tranexamic-acid after lung surgery reduces postoperative bleeding and blood transfusion volume. The topical administration of tranexamic-acid is safe without increasing the risk of post-operative complications related to pharmacological side-effects.
authors: Thoracic Surgery Operative Unit, S.Orsola Malpighi University Hospital, Bologna, Italy. dellamore76@libero.it
authors: Andrea
authors: A
authors: Dell'Amore
authors: Guido
authors: G
authors: Caroli
authors: Asadi
authors: A
authors: Nizar
authors: Nicola
authors: N
authors: Cassanelli
authors: Giulia
authors: G
authors: Luciano
authors: Domenico
authors: D
authors: Greco
authors: Giampiero
authors: G
authors: Dolci
authors: Alessandro
authors: A
authors: Bini
authors: Franco
authors: F
authors: Stella
mesh_terms: D000287:Administration, Topical; D000368:Aged; D000933:Antifibrinolytic Agents / Q000008:administration & dosage* / Q000009:adverse effects; D016063:Blood Loss, Surgical / Q000517:prevention & control*; D001803:Blood Transfusion; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019106:Postoperative Hemorrhage / Q000097:blood / Q000517:prevention & control*; D011446:Prospective Studies; D013903:Thoracic Surgery; D014148:Tranexamic Acid / Q000008:administration & dosage* / Q000009:adverse effects
chemical_list: D000933:Antifibrinolytic Agents; D014148:Tranexamic Acid