Evidence map›Paper›PMID 33993459›Full record

ReviewCanadian journal of anaesthesia = Journal canadien d'anesthesie2021

Tranexamic acid: current use in obstetrics, major orthopedic, and trauma surgery.

Jean Wong, Ronald B George, Ciara M Hanley, Chadi Saliba, Doreen A Yee, Angela Jerath

Registry-linked trialOpen access · bronzeAbstract readReview
PubMed Publisher
In one paragraph

Review in Canadian journal of anaesthesia = Journal canadien d'anesthesie, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07392034 (Efficacy of Tranexamic Acid Reducing Blood Loss During Maxillofacial Trauma Surgery), which is not on this map. Cited by 25 papers, 9 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
25citing papers in PubMed, 9 pooled it
6.6field-weighted citation impact, top 2% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT07392034 phase2completednot on this mapstarted 2025, after this paper: background citation

Efficacy of Tranexamic Acid Reducing Blood Loss During Maxillofacial Trauma Surgery

TypeinterventionalSponsorNishtar Medical UniversityRan2025 to 2025Enrolled60ConditionsHemoglobin Level Measurement, Blood Loss During Surgery, Duration of SurgeryArmsTranexamic Acid (TXA), Normal saline
3 · Its place in the literature

Who cites it

25 citing papers in PubMed, 9 syntheses or guidelines pooled it, 60 citations in OpenAlex.

  1. Pooled it
  2. Tranexamic acid in endoscopic sinus surgery: an updated systematic review and meta-analysis of randomized controlled trials.European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery · 2025
    Pooled it
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  4. Nebulized tranexamic acid for treatment of post-tonsillectomy bleeding: a systematic review and meta-analysis.European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery · 2025
    Pooled it
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  8. Tranexamic acid in head and neck procedures: a systematic review and meta-analysis of randomized controlled trials.European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery · 2022
    Pooled it
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 3 institutions in 2 countries.

Jean WongDepartment of Anesthesia and Pain Management, Toronto Western Hospital, University Health Network and Women's College Hospital, Toronto, ON, Canada.
Ronald B GeorgeDepartment of Anesthesia and Perioperative Care, UCSF, San Francisco, CA, USA.
Ciara M HanleyDepartment of Anesthesia, Sunnybrook Health Science Centre, Toronto, ON, Canada.
Chadi SalibaDepartment of Anesthesia, Sunnybrook Health Science Centre, Toronto, ON, Canada.
Doreen A YeeDepartment of Anesthesia, Sunnybrook Health Science Centre, Toronto, ON, Canada.
Angela JerathDepartment of Anesthesia, Sunnybrook Health Science Centre, Toronto, ON, Canada. Angela.Jerath@mail.utoronto.ca.
University of Toronto · CASunnybrook Health Science Centre · CAUniversity of California, San Francisco · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeIn this Continuing Professional Development module, we review the practical pharmacology of tranexamic acid and its clinical use in trauma, obstetrics, and major orthopedic surgery. PRINCIPAL

findingsTranexamic acid is a synthetic drug that inhibits fibrinolysis. Multiple clinical trials in various clinical settings have shown that it can reduce blood loss, transfusion rates, and bleeding-associated mortality. In trauma and obstetrical bleeding, early tranexamic acid administration (< three hours) may have greater clinical benefits. Overall, tranexamic acid use appears safe with no significant increase of thromboembolic or seizure events. Nevertheless, current evidence has limitations related to wide heterogeneity in dose, route, and timing of drug administration, as well as generalizability of the large-scale trial findings to higher income nations.

conclusionsTranexamic acid is an efficacious and safe pharmacological-based blood conservation technique in the management of clinically significant hemorrhage. All anesthesiologists should have a good understanding of the pharmacotherapeutic properties and perioperative role of tranexamic acid therapy both inside and outside of the operating room. The use of tranexamic acid is likely to continue to rise with endorsement by various clinical guidelines and healthcare organizations. Further quantitative research is needed to evaluate optimal dosing and drug efficacy in these clinical scenarios.

Indexed as

Antifibrinolytic AgentsObstetricsTranexamic AcidBlood Loss, SurgicalBlood TransfusionHemorrhageHumansAntifibrinolytic AgentsTranexamic Acid

Identifiers

PMID33993459
OpenAlexW3160112215

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.