Transfusion requirements in burn patients undergoing primary wound excision: effect of tranexamic acid.
BACKGROUND
Early excision of burn wounds is the standard approach for burns, but it is usually associated with the need of allogeneic blood transfusion. Our aim was to determine if intravenous administration of tranexamic acid (TXA) was able to reduce packed red blood cell (pRBC) transfusion requirements in burn patients.


METHODS
We conducted a retrospective cohort study of 2 consecutive series of severely burned patients (≥20% total body surface are) admitted for primary burn surgery. We searched for differences in pRBC transfusion occurrence and requirements during surgery and up to 24 hours after surgery.


RESULTS
A total of 107 patients were included in the study, and 48.6% (52 patients) received TXA during primary excision. The use of TXA exhibited an absolute risk reduction in the need for transfusion during surgery of 24.2% (95% CI: 7.1-41.4%). In total, patients receiving TXA required 1.6 units of pRBC in the perioperative period vs. 2.6 units in those not receiving TXA (P=0.017).


CONCLUSIONS
The intraoperative use of TXA in burn patients undergoing primary burn excision reduced the incidence of allogeneic transfusion and the total number of pRBC transfused.
Burn Center, Department of Anesthesia and Intensive Care, La Paz University Hospital, Madrid, Spain - adrh22@gmail.com.
Ana
A
Domínguez
Burn Center, Department of Anesthesia and Intensive Care, La Paz University Hospital, Madrid, Spain.
Estíbaliz
E
Alsina
Burn Center, Department of Plastic, Cosmetic and Reconstructive Surgery, La Paz University Hospital, Madrid, Spain.
Luis
L
Landín
Department of Anesthesia and Intensive Care, Segovia General Hospital, Segovia, Spain.
Javier F
JF
García-Miguel
Burn Center, Department of Plastic, Cosmetic and Reconstructive Surgery, La Paz University Hospital, Madrid, Spain.
Cesar
C
Casado
Burn Center, Department of Anesthesia and Intensive Care, La Paz University Hospital, Madrid, Spain.
Fernando
F
Gilsanz
D000328:Adult; D000368:Aged; D000933:Antifibrinolytic Agents / Q000627:therapeutic use*; D001803:Blood Transfusion / Q000706:statistics & numerical data*; D002056:Burns / Q000601:surgery*; D017707:Erythrocyte Transfusion; D005260:Female; D006801:Humans; D007430:Intraoperative Care; D008297:Male; D008875:Middle Aged; D057725:Operative Blood Salvage; D012189:Retrospective Studies; D040242:Risk Reduction Behavior; D016038:Skin Transplantation; D014148:Tranexamic Acid / Q000627:therapeutic use*; D016896:Treatment Outcome
D000933:Antifibrinolytic Agents; D014148:Tranexamic Acid