Increasing number of IV TXA doses further improves efficacy without increasing VTE risk in THA .
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Multiple-Dose Intravenous Tranexamic Acid Further Reduces Hidden Blood Loss After Total Hip Arthroplasty: A Randomized Controlled Trial
J Arthroplasty. 2018 Sep;33(9):2940-2945. doi: 10.1016/j.arth.2018.04.024150 patients scheduled for total hip arthroplasty and administered an intravenous dose of tranexamic acid prior to incision were randomized to either an additional 2, 3, or 4 IV TXA doses after 3 hour intervals thereafter. Patients were assessed for hidden blood loss, total blood loss, intraoperative blood loss, hemoglobin drop, transfusion rate, length of hospital stay, and incidence of thromboembolic complications. Results demonstrated significantly lower hidden blood loss, lower total blood loss, and smaller Hb drop in the 4 dose group compared with either the 3 or 2 dose group, though no transfusion was required in any group. No cases symptomatic deep vein thrombosis or pulmonary embolism were recorded; asymptomatic intramuscular thromboembolism rate ranged from 6-12% among the three groups.
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