title: Eliminating the use of allogeneic blood products in adolescent idiopathic scoliosis surgery.
abstract: OBJECTIVE
  The aim of this study was to compare transfusion requirements in patients before and after the introduction of tranexamic acid as standard in patients undergoing spinal surgery for idiopathic scoliosis in a national orthopaedic hospital.
  
  
  METHODS
  A retrospective chart review of 56 idiopathic scoliosis patients who underwent posterior spinal instrumentation and fusion between 2009 and 2013 at our institution. Preoperative, intraoperative, and postoperative data were measured.
  
  
  RESULTS
  Patients who received tranexamic acid as standard (n = 31) showed a trend towards a decrease in transfusion requirements compared with those who received no tranexamic acid (n = 25). These patients had a statistically significant decrease in operative time (223 vs 188 min, p = 0.005), and estimated intraoperative blood loss was reduced by nearly 50% in the tranexamic acid group. They also had an associated reduced decrease in haemoglobin between preoperative and postoperative levels (4 vs 5 g/dL, p = 0.01).
  
  
  CONCLUSIONS
  Since February 2012, no patient has required intraoperative or postoperative allogeneic blood product transfusion in this hospital. The routine use of antifibrinolytic medications in patients undergoing surgery for adolescent idiopathic scoliosis has effectively eliminated the need for allogeneic blood products.
authors: Cappagh National Orthopaedic Hospital, Finglas, Dublin 11, Ireland, markjberney@gmail.com.
authors: Mark J
authors: MJ
authors: Berney
authors: Peter H
authors: PH
authors: Dawson
authors: Margaret
authors: M
authors: Phillips
authors: Darren F
authors: DF
authors: Lui
authors: Paul
authors: P
authors: Connolly
mesh_terms: D000293:Adolescent; D000933:Antifibrinolytic Agents / Q000008:administration & dosage*; D016063:Blood Loss, Surgical; D001803:Blood Transfusion / Q000706:statistics & numerical data*; D005260:Female; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D016268:Internal Fixators; D007902:Length of Stay; D008297:Male; D061646:Operative Time; D011184:Postoperative Period; D057234:Preoperative Period; D012189:Retrospective Studies; D012600:Scoliosis / Q000601:surgery*; D013123:Spinal Fusion / Q000295:instrumentation; D014148:Tranexamic Acid / Q000032:analysis*
chemical_list: D000933:Antifibrinolytic Agents; D006454:Hemoglobins; D014148:Tranexamic Acid