Tranexamic acid in peadiatric scoliosis surgery (TRIPSS): A prospective randomised trial comparing high dose and low dose tranexamic acid in adolescent idiopathic scoliosis undergoing posterior spinal fusion / Siti Nadzrah Yunus
Background: Tranexamic Acid (TXA) is commonly used in scoliosis surgery to reduce the amount surgical blood loss and allogenic blood transfusion requirement. Evidence on proper dosing regimen of TXA in paediatric population is scarce. This trial was designed to determine the effectiveness of high...
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| Format: | Thesis |
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2019
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| Online Access: | http://studentsrepo.um.edu.my/11204/ http://studentsrepo.um.edu.my/11204/4/siti.pdf |
| _version_ | 1848774323473481728 |
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| author | Siti Nadzrah, Yunus |
| author_facet | Siti Nadzrah, Yunus |
| author_sort | Siti Nadzrah, Yunus |
| building | UM Research Repository |
| collection | Online Access |
| description | Background: Tranexamic Acid (TXA) is commonly used in scoliosis surgery to reduce
the amount surgical blood loss and allogenic blood transfusion requirement. Evidence
on proper dosing regimen of TXA in paediatric population is scarce. This trial was
designed to determine the effectiveness of high dose TXA over low dose TXA in
adolescent idiopathic scoliosis surgery to reduce surgical blood loss and allogenic
transfusion requirement.
Methods: This prospective randomised double-blinded trial involved 166 patients with
adolescents idiopathic scoliosis in University Malaya Medical Centre (UMMC) who
were randomised to receive either Group A, high dose TXA (30 mg/kg loading dose and
10 mg/kg/h infusion) or Group B, low dose TXA (10 mg/kg loading dose and 1
mg/kg/h). Haemoglobin, haematocrit and fibrinogen levels were obtained at 3
perioperative time frames; T1 (preoperation), T2 (0-hour postoperation), and T3 (48-
hour postoperation) which was then analysed using repeated measure analysis of
variance (ANOVA) to detect the difference over time.
Results: The total surgical blood loss was insignificantly different (p = 0.865). Each
group has one patient received perioperative allogenic blood transfusion. The main
predictors contributing to the amount of surgical blood loss are number of vertebral
level fused, duration of surgery and gender (R2
= 0.492). The perioperative drop in
haemoglobin levels between T1 and T3 for Group A and Group B (mean difference
[95% confidence interval], 3.01 [2.60,3.42] versus 3.30 [2.89,3.71]) showed no
significant difference (p = 0.511). No serious complications occurred in both groups.
iv
Conclusions: Low dose TXA is as effective as high dose TXA in reduction of surgical
blood loss and transfusion requirement in paediatric scoliosis surgery.
Keywords
Tranexamic acid, adolescent idiopathic scoliosis, blood loss, allogenic blood transfusion |
| first_indexed | 2025-11-14T13:56:29Z |
| format | Thesis |
| id | um-11204 |
| institution | University Malaya |
| institution_category | Local University |
| last_indexed | 2025-11-14T13:56:29Z |
| publishDate | 2019 |
| recordtype | eprints |
| repository_type | Digital Repository |
| spelling | um-112042022-01-02T22:22:25Z Tranexamic acid in peadiatric scoliosis surgery (TRIPSS): A prospective randomised trial comparing high dose and low dose tranexamic acid in adolescent idiopathic scoliosis undergoing posterior spinal fusion / Siti Nadzrah Yunus Siti Nadzrah, Yunus RD Surgery Background: Tranexamic Acid (TXA) is commonly used in scoliosis surgery to reduce the amount surgical blood loss and allogenic blood transfusion requirement. Evidence on proper dosing regimen of TXA in paediatric population is scarce. This trial was designed to determine the effectiveness of high dose TXA over low dose TXA in adolescent idiopathic scoliosis surgery to reduce surgical blood loss and allogenic transfusion requirement. Methods: This prospective randomised double-blinded trial involved 166 patients with adolescents idiopathic scoliosis in University Malaya Medical Centre (UMMC) who were randomised to receive either Group A, high dose TXA (30 mg/kg loading dose and 10 mg/kg/h infusion) or Group B, low dose TXA (10 mg/kg loading dose and 1 mg/kg/h). Haemoglobin, haematocrit and fibrinogen levels were obtained at 3 perioperative time frames; T1 (preoperation), T2 (0-hour postoperation), and T3 (48- hour postoperation) which was then analysed using repeated measure analysis of variance (ANOVA) to detect the difference over time. Results: The total surgical blood loss was insignificantly different (p = 0.865). Each group has one patient received perioperative allogenic blood transfusion. The main predictors contributing to the amount of surgical blood loss are number of vertebral level fused, duration of surgery and gender (R2 = 0.492). The perioperative drop in haemoglobin levels between T1 and T3 for Group A and Group B (mean difference [95% confidence interval], 3.01 [2.60,3.42] versus 3.30 [2.89,3.71]) showed no significant difference (p = 0.511). No serious complications occurred in both groups. iv Conclusions: Low dose TXA is as effective as high dose TXA in reduction of surgical blood loss and transfusion requirement in paediatric scoliosis surgery. Keywords Tranexamic acid, adolescent idiopathic scoliosis, blood loss, allogenic blood transfusion 2019 Thesis NonPeerReviewed application/pdf http://studentsrepo.um.edu.my/11204/4/siti.pdf Siti Nadzrah, Yunus (2019) Tranexamic acid in peadiatric scoliosis surgery (TRIPSS): A prospective randomised trial comparing high dose and low dose tranexamic acid in adolescent idiopathic scoliosis undergoing posterior spinal fusion / Siti Nadzrah Yunus. Masters thesis, Universiti Malaya. http://studentsrepo.um.edu.my/11204/ |
| spellingShingle | RD Surgery Siti Nadzrah, Yunus Tranexamic acid in peadiatric scoliosis surgery (TRIPSS): A prospective randomised trial comparing high dose and low dose tranexamic acid in adolescent idiopathic scoliosis undergoing posterior spinal fusion / Siti Nadzrah Yunus |
| title | Tranexamic acid in peadiatric scoliosis surgery (TRIPSS): A prospective randomised trial comparing high dose and low dose tranexamic acid in adolescent idiopathic scoliosis undergoing posterior spinal fusion / Siti Nadzrah Yunus |
| title_full | Tranexamic acid in peadiatric scoliosis surgery (TRIPSS): A prospective randomised trial comparing high dose and low dose tranexamic acid in adolescent idiopathic scoliosis undergoing posterior spinal fusion / Siti Nadzrah Yunus |
| title_fullStr | Tranexamic acid in peadiatric scoliosis surgery (TRIPSS): A prospective randomised trial comparing high dose and low dose tranexamic acid in adolescent idiopathic scoliosis undergoing posterior spinal fusion / Siti Nadzrah Yunus |
| title_full_unstemmed | Tranexamic acid in peadiatric scoliosis surgery (TRIPSS): A prospective randomised trial comparing high dose and low dose tranexamic acid in adolescent idiopathic scoliosis undergoing posterior spinal fusion / Siti Nadzrah Yunus |
| title_short | Tranexamic acid in peadiatric scoliosis surgery (TRIPSS): A prospective randomised trial comparing high dose and low dose tranexamic acid in adolescent idiopathic scoliosis undergoing posterior spinal fusion / Siti Nadzrah Yunus |
| title_sort | tranexamic acid in peadiatric scoliosis surgery (tripss): a prospective randomised trial comparing high dose and low dose tranexamic acid in adolescent idiopathic scoliosis undergoing posterior spinal fusion / siti nadzrah yunus |
| topic | RD Surgery |
| url | http://studentsrepo.um.edu.my/11204/ http://studentsrepo.um.edu.my/11204/4/siti.pdf |