Dados do Trabalho

Título

Topical versus intravenous tranexamic acid in open cardiac surgery: a systematic review and meta-analysis

Resumo

Introduction: Tranexamic acid is a commonly employed intervention to minimize bleeding during cardiac surgery. It can be administered either topically or intravenously. The objective of this study was to perform a comprehensive meta-analysis to compare the efficacy of these two administration methods.
Objective: The aim of our study was to conduct a meta-analysis comparing the outcomes of topical tranexamic acid (topical TxA) with intravenous tranexamic acid (IV TxA) in patients who underwent cardiac surgery.
Method: To conduct this study, we employed the PRISMA methodology and conducted searches in the PUBMED, EMBASE and COCHRANE databases. Our focus was on randomized clinical trials that compared the use of topical TxA and IV TxA in patients who underwent cardiac surgery. Using the random-effects model, we pooled the effects of these interventions in a meta-analysis. The primary outcomes we examined were mortality, seizure, and reoperation. Statistical analysis was carried out using RevMan 5.1.7.
Results: We conducted a comprehensive analysis involving a total of 3389 patients from 3 randomized controlled trials. These trials focused on the use of topical tranexamic acid to control bleeding in cardiac surgery. The patients included in the studies were predominantly male, accounting for 77.75% of the total. The duration of follow-up ranged from 3 months to 4 years. After the cardiac surgery procedure, we observed the following outcomes: all-cause mortality (OR: 0.95; 95% CI 0.35-2.57; p= 0.92; I² 14%), seizure occurrence (OR: 0.36; 95% CI 0.12-1.05; p= 0.06; I² 0%), and the need for reoperation (OR: 0.91; 95% CI 0.12-1.05; p= 0.90; I² 31%).
Conclusion: Our comprehensive analysis reveals that when comparing mortality, seizure, and reoperation outcomes between topical TxA and IV TxA, there is no significant disparity observed in the outcomes of these two groups.

Palavras Chave

topical tranexamic acid; intravenous tranexamic acid; cardiac surgery

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