While giving a single dose of tranexamic acid perioperatively is recognized for reducing the likelihood of red blood cell transfusion, concern about thrombosis has been a key barrier to use in noncardiac surgery.A large randomized trial showed that in high transfusion-risk noncardiac surgeries, tranexamic acid didn't increase risk of thromboembolism at 90 days.Experts suggested the trial data should encourage more widespread use of tranexamic acid in this setting and called for implementation efforts.
A hospital policy of giving high transfusion-risk patients tranexamic acid for noncardiac surgery reduced blood transfusions without increasing thromboembolic risk, the TRACTION randomized trial showed.
Hospitals giving tranexamic acid saw 27% fewer red-cell transfusions during hospitalization of these patients compared with placebo (7.4% vs 9.8%, relative risk [RR] 0.73, 95% CI 0.61-0.86), Ryan Zarychanski, MD, of the University of Manitoba in Winnipeg, and colleagues reported in the New England Journal of Medicine.
The rate of venous thromboembolism within 90 days was 2.1% in both groups (RR 0.96, 95% CI 0.65-1.38), which met the criterion for noninferiority, the researchers also reported at the Critical Care Reviews meeting in Belfast, Ireland.
