1.
Use of aprotinin to reduce blood loss and transfusion in major orthopedic surgery: a meta-analysis
Huang F, Zhao Q, Guo C, Ma G, Wang Q, Yin Y, Wu Y
Transfusion & Apheresis Science. 2014;51((2):):152-61.
Abstract
BACKGROUD Conflicting reports have been published regarding the effectiveness and safety of aprotinin in reducing blood loss and transfusion in patients undergoing orthopedic surgery. We performed a meta-analysis to evaluate the effectiveness and safety of aprotinin in reducing blood loss and transfusion in major orthopedic surgery. MATERIALS AND METHODS MEDLINE, PubMed, EMBASE and Cochrane databases were searched for relevant studies. Only randomized controlled trials were eligible for this study. The weighted mean difference in blood loss, and number of transfusions per patient and the summary risk ratio of transfusion requirements, and deep-vein thrombosis (DVT) were calculated in the aprotinin-treated group and the control group. RESULTS Eighteen randomized controlled trials involving 1276 patients were included. The use of aprotinin reduced total blood loss by a mean of 498.88ml (95% confidence interval [CI]; -735.03 to -262.72), intra-operative blood loss by a mean of 246.11ml (95% CI; -352.11 to -140.11), post-operative blood loss by a mean of 169.11ml (95% CI; -234.06 to -105.55), the number of blood transfusions per patient by 0.93 units (95% CI; -1.36 to -0.51). Aprotinin led to a signficant reduction in transfusion requirements (RR 0.59; 95% CI; 0.51 to 0.69) and no increase in the risk of DVT (RR 0.58; 95% CI; 0.38 to 1.08). CONCLUSION The meta-analysis shows that aprotinin could significantly reduce blood loss and blood transfusion requirements in patients undergoing orthopedic surgery, and it did not appear to increase the risk of DVT.Copyright 2014 Elsevier Ltd. All rights reserved.
2.
The use of tranexamic acid to reduce blood loss and transfusion in major orthopedic surgery: a meta-analysis
Huang F, Wu D, Ma G, Yin Z, Wang Q
Journal of Surgical Research. 2014;186((1):):318-27.
Abstract
BACKGROUND Conflicting reports have been published regarding the effect of tranexamic acid (TXA) on reducing blood loss and transfusion in patients undergoing orthopedic surgery. We performed a meta-analysis to evaluate the effectiveness and safety of TXA treatment in reducing blood loss and transfusion in major orthopedic surgery. MATERIALS AND METHODS MEDLINE, PubMed, EMBASE, and Cochrane databases were searched for relevant studies. Only randomized controlled trials were eligible for this study. The weighted mean difference in blood loss, number of transfusions per patient, and the summary risk ratio of transfusion and deep vein thrombosis (DVT) were calculated in the TXA-treated group and the control group. RESULTS A total of 46 randomized controlled trials involving 2925 patients were included. The use of TXA reduced total blood loss by a mean of 408.33mL (95% confidence interval [CI], -505.69 to -310.77), intraoperative blood loss by a mean of 125.65mL (95% CI, -182.58 to -68.72), postoperative blood loss by a mean of 214.58mL (95% CI, -274.63 to -154.52), the number of blood transfusions per patient by 0.78U (95% CI, -0.19 to -0.37), and the volumes of blood transfusions per patient by 205.33mL (95% CI, -301.37 to -109.28). TXA led to a significant reduction in transfusion requirements (relative risk, 0.51; 95% CI, 0.46-0.56), and no increase in the risk of DVT (relative risk, 1.11; 95% CI, 0.69-1.79). CONCLUSIONS TXA significantly reduced blood loss and blood transfusion requirements in patients undergoing orthopedic surgery, and did not appear to increase the risk of DVT. Crown Copyright 2014. Published by Elsevier Inc. All rights reserved.