Evidence map›Paper›PMID 39425234›Full record

ArticleTrials2024

Tranexamic Acid for reduction of intra- and postoperative TRansfusion requirements in elective Abdominal surgery (TATRA): study protocol for an investigator-initiated, multicenter, double-blind, placebo-controlled, randomized superiority trial with two parallel groups.

Ulrich Ronellenfitsch, Anita Kestel, Johannes Klose, Artur Rebelo, Michael Bucher, Daniel Ebert, Rafael Mikolajczyk, Andreas Wienke, Thomas Kegel, Julian Hering and 6 more

Registry-linked trialAbstract readClinical Trial Protocol
In one paragraph

Article in Trials, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06414031 (Tranexamic Acid for Reduction of Intra- and Postoperative Transfusion Requirements in Elective Abdominal Surgery), which is not on this map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
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.

NCT06414031 phase3recruitingnot on this map

Tranexamic Acid for Reduction of Intra- and Postoperative Transfusion Requirements in Elective Abdominal Surgery: Randomized Controlled Trial

TypeinterventionalSponsorUlrich Ronellenfitsch, MDRan2024 to 2026Enrolled850ConditionsSurgical Blood Loss, Transfusion-dependent Anemia, Abdomen DiseaseArmsTranexamic Acid, Placebo
3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
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

16 authors.

Ulrich RonellenfitschDepartment of Abdominal, Vascular and Endocrine Surgery, University Hospital Halle (Saale), Halle (Saale), Germany. ulrich.ronellenfitsch@uk-halle.de.ORCID http://orcid.org/0000-0003-1107-813X
Anita KestelDepartment of Abdominal, Vascular and Endocrine Surgery, University Hospital Halle (Saale), Halle (Saale), Germany.
Johannes KloseDepartment of Abdominal, Vascular and Endocrine Surgery, University Hospital Halle (Saale), Halle (Saale), Germany.
Artur RebeloDepartment of Abdominal, Vascular and Endocrine Surgery, University Hospital Halle (Saale), Halle (Saale), Germany.
Michael BucherDepartment of Anesthesiology and Operative Intensive Care, University Hospital Halle (Saale), Halle (Saale), Germany.
Daniel EbertDepartment of Anesthesiology and Operative Intensive Care, University Hospital Halle (Saale), Halle (Saale), Germany.
Rafael MikolajczykMedical Faculty, Institute for Medical Informatics, Biometry and Informatics, Martin-Luther-University Halle (Saale), Halle (Saale), Germany.
Andreas WienkeMedical Faculty, Institute for Medical Informatics, Biometry and Informatics, Martin-Luther-University Halle (Saale), Halle (Saale), Germany.
Thomas KegelDepartment of Internal Medicine IV (Hematology and Oncology), University Hospital Halle (Saale), Halle (Saale), Germany.
Julian HeringDepartment of Abdominal, Vascular and Endocrine Surgery, University Hospital Halle (Saale), Halle (Saale), Germany.
Christian HaidukMedical Faculty, Coordinating Center for Clinical Studies, Martin-Luther-University Halle (Saale), Halle (Saale), Germany.
Michael RichterMedical Faculty, Coordinating Center for Clinical Studies, Martin-Luther-University Halle (Saale), Halle (Saale), Germany.
Jörg SteighardtMedical Faculty, Coordinating Center for Clinical Studies, Martin-Luther-University Halle (Saale), Halle (Saale), Germany.
Erich GrohmannDeutsche ILCO e.V., Association for Persons With Ostomies and Colon Cancer, Bonn, Germany.
Lutz OttoArbeitskreis der Pankreatektomierten e.V., Working Group of Pancreatectomized Persons, Magdeburg, Germany.
Jörg KleeffDepartment of Abdominal, Vascular and Endocrine Surgery, University Hospital Halle (Saale), Halle (Saale), Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundIntra- and postoperative hemorrhage is a relevant problem in major abdominal surgery, leading to acute anemia and necessitating transfusion of packed red blood cells. It is estimated that in 30% of abdominal surgeries, intra- or postoperative transfusion is required. Transfusion potentially has detrimental health effects and poses a considerable socioeconomic burden. Tranexamic acid, a lysine analog inhibiting plasminogen activation and providing clot stability, has been used to reduce hemorrhage. While there is ample evidence in other surgical disciplines, it is almost completely lacking in abdominal surgery.

methodsThis multicenter double-blind parallel group randomized superiority trial will compare tranexamic acid (loading dose 1000 mg over 10 min prior to skin incision, maintenance dose 125 mg/h continuously until skin closure or until 1000 mg have been administered) to placebo in patients ≥ 18 years undergoing elective esophagectomy, gastrectomy, colectomy, rectal resection, pancreatic resection, or hepatectomy. The primary efficacy endpoint is the intra- or postoperative transfusion of at least one unit of packed red blood cells. Key secondary endpoints are the number of transfused units per patient, estimated intraoperative blood loss, postoperative complications/mortality, length of hospital stay, operation/anesthesia time, D-dimer levels, and quality of life. Sample size calculation is based on the assumption that in the control group, 30% of patients require transfusion while the intervention achieves a risk reduction of 33%, reducing the probability to 20%. With a type one error of 5% and a power of 90%, using a two-sided χ DISCUSSION: If the proposed trial yielded positive results, the routine use of tranexamic acid in major abdominal surgery would be supported. This would avoid acute anemia with detrimental effects such as tissue hypoxia and organ injury, as well as the negative immediate and delayed effects of transfusions.

trial registrationEU CT Nr: 2023-509970-43-01, NCT06414031 . Registered on 10 May 2024.

Indexed as

Antifibrinolytic AgentsElective Surgical ProceduresMulticenter Studies as TopicTranexamic AcidAbdomenBlood Loss, SurgicalBlood TransfusionDouble-Blind MethodEquivalence Trials as TopicHumansPostoperative HemorrhageRandomized Controlled Trials as TopicTime FactorsTreatment OutcomeAntifibrinolytic AgentsTranexamic AcidAbdominal surgeryBlood transfusionPatient blood managementPerioperative bleedingTranexamic acid

Identifiers

PMID39425234
PMCPMC11490177

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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.