The Perioperative Application of Tranexamic Acid

Carsten Perka; Christian von Heymann; Heiko Lier; Lutz Kaufner; Sascha Treskatsch

doi:10.1055/a-2055-8178

Zeitschrift für Orthopädie und Unfallchirurgie, Table of Contents

Z Orthop Unfall 2023; 161(05): 532-537
DOI: 10.1055/a-2055-8178

Review

Die perioperative Gabe von Tranexamsäure

Empfehlung der Arbeitsgemeinschaft Endoprothetik in Zusammenarbeit mit einer Expertengruppe der Deutschen Gesellschaft für Anästhesiologie und Intensivmedizin Update Februar 2023 Article in several languages: English | deutsch

Carsten Perka

¹Klinik für Orthopädie, Centrum für Muskuloskeletale Chirurgie, Charité - Universitätsmedizin Berlin, Berlin, Deutschland (Ringgold ID: RIN14903)

,

Christian von Heymann

²Klinik für Anästhesie, Intensivmedizin, Notfallmedizin und Schmerztherapie, Vivantes Klinikum im Friedrichshain, Berlin, Berlin, Deutschland

,

Heiko Lier

³Klinik für Anästhesiologie und Operative Intensivmedizin, Medizinische Fakultät und Uniklinik Köln, Köln, Deutschland

,

Lutz Kaufner

⁴Klinik für Anästhesiologie mit Schwerpunkt operative Intensivmedizin, Charité ‒ Universitätsmedizin Berlin, Berlin, Deutschland (Ringgold ID: RIN14903)

,

Sascha Treskatsch

⁴Klinik für Anästhesiologie mit Schwerpunkt operative Intensivmedizin, Charité ‒ Universitätsmedizin Berlin, Berlin, Deutschland (Ringgold ID: RIN14903)

› Author Affiliations

Abstract

Zusammenfassung

Der Einsatz von Tranexamsäure (TXA) hat in den letzten Jahren bei der Durchführung endoprothetischer Operationen stark zugenommen. Die Möglichkeit, den Blutverlust zu reduzieren, die Zahl der Transfusionen zu vermindern und meist auf Drainagen zu verzichten, lassen den Einsatz von TXA immer mehr als „Standard“ erscheinen. Andererseits besteht keine Zulassung von TXA für den Einsatz bei endoprothetischen Eingriffen. Aus diesem Grund sollte unbedingt immer einen Nutzen-Risiko-Analyse erfolgen. Eine prophylaktische TXA-Gabe ohne Aufklärung ist daher gerechtfertigt, wenn eine fibrinolysebedingte Blutung zu erwarten ist und keine Kontraindikationen oder Risikofaktoren für thromboembolische Komplikationen vorliegen. Eine Aufklärung ist auch nicht erforderlich, wenn im Rahmen einer fibrinolysebedingten Blutung eine therapeutische TXA-Gabe erfolgt. Der nach gegenwärtigem Kenntnisstand optimale Zeitpunkt, die möglichen Applikationswege und die Dosierungsempfehlungen werden in der vorliegenden Handlungsempfehlung dargestellt.

Schlüsselwörter

Tranexamsäure - Fibrinolyse - Hyperfibrinolyse - Blutverlust

Full Text

References

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