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Cell salvage for minimising perioperative allogeneic blood transfusion in adults undergoing elective surgery
CONCLUSIONS: In some types of elective surgery, cell salvage may reduce the need for and volume of allogeneic transfusion, alongside evidence of no difference in adverse events, when compared to no cell salvage. Further research is required to establish why other surgeries show no benefit from CS, through further analysis of the current evidence. More large RCTs in under-reported specialities are needed to expand the evidence base for exploring the impact of CS.PMID:37681564 | PMC:PMC10486190 | DOI:10.1002/14651858.CD001888.pub5
Source: Cochrane Database of Systematic Reviews - September 8, 2023 Category: General Medicine Authors: Thomas D Lloyd Louise J Geneen Keeley Bernhardt William McClune Scott J Fernquest Tamara Brown Carolyn Dor ée Susan J Brunskill Michael F Murphy Antony Jr Palmer Source Type: research

Pharmacological interventions for the prevention of bleeding in people undergoing definitive fixation or joint replacement for  hip, pelvic and long bone fractures
CONCLUSIONS: We cannot draw conclusions from the current evidence due to lack of data. Most published studies included in our analyses assessed the use of tranexamic acid (compared to placebo, or using different routes of administration). We identified 27 prospectively registered ongoing RCTs (total target recruitment of 4177 participants by end of 2023). The ongoing trials create six new comparisons: tranexamic acid (tablet + injection) versus placebo; intravenous tranexamic acid versus oral tranexamic acid; topical tranexamic acid versus oral tranexamic acid; different intravenous tranexamic acid dosing regimes; topical ...
Source: Cochrane Database of Systematic Reviews - June 5, 2023 Category: General Medicine Authors: Victoria N Gibbs Rita Champaneria Louise J Geneen Parag Raval Carolyn Dor ée Susan J Brunskill Alex Novak Antony Jr Palmer Lise J Estcourt Source Type: research

Antifibrinolytic drugs for acute traumatic injury.
CONCLUSIONS: TXA safely reduces mortality in trauma patients with bleeding without increasing the risk of adverse events.  TXA should be given as early as possible and within three hours of injury, as further analysis of the CRASH-2 trial showed that treatment later than this is unlikely to be effective and may be harmful. Although there is some promising evidence for the effect of TXA in patients with TBI, substantial uncertainty remains.Two ongoing trials being conducted in patients with isolated TBI should resolve these remaining uncertainties. PMID: 25956410 [PubMed - as supplied by publisher]
Source: Cochrane Database of Systematic Reviews - May 9, 2015 Category: Journals (General) Authors: Ker K, Roberts I, Shakur H, Coats TJ Tags: Cochrane Database Syst Rev Source Type: research

Tranexamic acid for reducing mortality in emergency and urgent surgery.
CONCLUSIONS: There is evidence that tranexamic acid reduces blood transfusion in patients undergoing emergency or urgent surgery. There is a need for a large pragmatic clinical trial to assess the effects of routine use of tranexamic acid on mortality in a heterogeneous group of urgent and emergency surgical patients. PMID: 23440847 [PubMed - in process]
Source: Cochrane Database of Systematic Reviews - March 2, 2013 Category: Journals (General) Authors: Perel P, Ker K, Morales Uribe CH, Roberts I Tags: Cochrane Database Syst Rev Source Type: research