Intravenous Tranexamic Acid Reduces Blood Loss and Transfusion Volume in Scoliosis Surgery for Spinal Muscular Atrophy: Results of a 20-Year Retrospective Analysis

Shih-Hsiang Chou, Sung-Yen Lin, Meng-Huang Wu, Yin-Chun Tien, Yuh-Jyh Jong, Wen-Chen Liang, Yen-Mou Lu, Chia-Lung Shih and Cheng-Chang Lu
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Shih-Hsiang Chou: Department of Orthopaedic Surgery, Kaohsiung Medical University Hospital, Kaohsiung 807, Taiwan
Sung-Yen Lin: Department of Orthopaedic Surgery, Kaohsiung Medical University Hospital, Kaohsiung 807, Taiwan
Meng-Huang Wu: Department of Orthopedics, Taipei Medical University Hospital, Taipei 11031, Taiwan
Yin-Chun Tien: Department of Orthopaedic Surgery, Kaohsiung Medical University Hospital, Kaohsiung 807, Taiwan
Yuh-Jyh Jong: Department of Pediatrics, Kaohsiung Medical University Hospital, Kaohsiung 807, Taiwan
Wen-Chen Liang: Department of Pediatrics, Kaohsiung Medical University Hospital, Kaohsiung 807, Taiwan
Yen-Mou Lu: Department of Orthopaedic Surgery, Kaohsiung Medical University Hospital, Kaohsiung 807, Taiwan
Chia-Lung Shih: Clinical Medicine Research Center, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chia-Yi City 600, Taiwan
Cheng-Chang Lu: Department of Orthopaedic Surgery, Kaohsiung Medical University Hospital, Kaohsiung 807, Taiwan

IJERPH, 2021, vol. 18, issue 19, 1-10

Abstract: Intravenous tranexamic acid (TXA) has been administered to reduce intraoperative blood loss in scoliosis surgery. However, the therapeutic effect of TXA on spinal muscular atrophy (SMA) scoliosis surgery is not well demonstrated. Therefore, this study aimed to assess the efficacy of intravenous TXA in SMA scoliosis surgery. From December 1993 to August 2020, 30 SMA patients who underwent scoliosis surgery (posterior fusion with fusion level of thoracic second or third to pelvis) were retrospectively enrolled and divided into the TXA group and non-TXA (control) group, with 15 patients in each group. Survey parameters were the amount of blood loss, blood transfusion, crystalloid transfusion volume, intubation time, and associated pulmonary complications (including pneumonia, pulmonary edema, and pulmonary atelectasis). The TXA group had significantly lesser blood loss than the control group ( p = 0.011). Compared with the control group, the TXA group had significantly lower blood transfusion ( p < 0.001), crystalloid volume ( p = 0.041), and total transfusion volume ( p = 0.005). In addition, the TXA group had fewer postoperative pulmonary complications, and patients with pulmonary complications were associated with a higher relative crystalloid volume and relative total transfusion volume ( p = 0.003 and 0.022, respectively). In conclusion, TXA can be effective in reducing intraoperative blood loss and crystalloid fluid transfusions during scoliosis surgery in SMA patients, which may aid in reducing postoperative pulmonary complications.

Keywords: blood loss; scoliosis surgery; spinal muscular atrophy; tranexamic acid; transfusion volume (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
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