Evidence map›Paper›PMID 39958575›Full record

Trial reportThe Pan African medical journal2024

[Effects of desmopressin versus tranexamic acid on reducing bleeding in knee arthroplasty: a double-blind randomized study].

Imen Zouche, Salma Ketata, Amir Sallemi, Mariem Bousarsar, Nizar Sahnoun, Mariem Keskes, Hichem Cheikhrouhou

Abstract readRandomized Controlled TrialComparative StudyEnglish Abstract
In one paragraph

Trial report in The Pan African medical journal, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed, 1 pooled it
–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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
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

7 authors.

Imen ZoucheService d'Anesthésie Réanimation Chirurgicale, Centre Hospitalier Universitaire Habib Bourguiba, Sfax, Tunisie.
Salma KetataService d'Anesthésie Réanimation Chirurgicale, Centre Hospitalier Universitaire Habib Bourguiba, Sfax, Tunisie.
Amir SallemiService d'Anesthésie Réanimation Chirurgicale, Centre Hospitalier Universitaire Habib Bourguiba, Sfax, Tunisie.
Mariem BousarsarService d'Anesthésie Réanimation Chirurgicale, Centre Hospitalier Universitaire Habib Bourguiba, Sfax, Tunisie.
Nizar SahnounService de Chirurgie Orthopédique, Centre Hospitalier Universitaire Habib Bourguiba, Sfax, Tunisie.
Mariem KeskesService d'Anesthésie Réanimation Chirurgicale, Centre Hospitalier Universitaire Habib Bourguiba, Sfax, Tunisie.
Hichem CheikhrouhouService d'Anesthésie Réanimation Chirurgicale, Centre Hospitalier Universitaire Habib Bourguiba, Sfax, Tunisie.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Introduction: although blood-sparing properties of tranexamic acid (TA) and desmopressin (Desmo) have been well described following various surgical procedures, few studies have compared the effect of Desmo to that of TA in total knee arthroplasty (TKA). The purpose of our study was to compare the effectiveness of TA and Desmo in reducing perioperative bleeding during TKA. Methods: we conducted a prospective double-blind study including patients undergoing TKA under spinal anesthesia, randomized into 2 groups: the Desmo group (patients received 0.3 μg/kg of Desmo in 100 ml of saline over 30 minutes before incision, followed by a saline infusion of 30 ml/kg over 12 hours) and the TA group (patients received 20 mg/kg of TA in 100 ml of saline over 30 minutes before incision, followed by 10 mg/kg of TA in 30 ml/kg of saline over 12 hours). The endpoints were perioperative bleeding, transfusion requirement and postoperative complications. Results: the study included 55 patients divided into 2 groups: TA group (28 patients) and Desmo group (27 patients). Blood accumulation in the jar during the procedure was significantly higher in the TA group (339±40 ml) than in the Desmo group (295±77 ml) (p=0.038). During the first 12 postoperative hours, additional blood accumulation in the redon was significantly higher in the Desmo group (h6: 288±55ml, H12: 383±63ml) compared to the TA group (h6: 188±42ml, h12: 287±60ml) with at H6: p= 0.001 and at H 12: p= 0.009. After 12 hours postoperatively, blood volume in the redon became similar in the 2 groups. From the time of discharge from the post-interventional monitoring room (PICU) to 2 days postoperatively, hemoglobin and hematocrit levels were similar in the 2 groups. Platelet count (PLT) was significantly higher in the Desmo group than in the TA group upon leaving the PICU (Pq desmo: 193929±25000 vs Pq AT: 157370±24300; p< 0.001) and on postoperative day 1 (Pq desmo: 178929±26200 vs Pq AT: 168929±25100; p= 0.048). By postoperative day 2, platelet counts became similar in the 2 groups. During the postoperative period, only one patient in the Desmo group required an allogeneic blood transfusion. No postoperative thromboembolic events were noted in our patients. Conclusion: both TA and desmopressin are comparably effective in reducing perioperative blood loss during TKA under spinal anesthesia.

Indexed as

Antifibrinolytic AgentsArthroplasty, Replacement, KneeBlood Loss, SurgicalDeamino Arginine VasopressinHemostaticsPostoperative HemorrhageTranexamic AcidAgedAnesthesia, SpinalBlood TransfusionDouble-Blind MethodFemaleHumansMaleMiddle AgedPostoperative ComplicationsAntifibrinolytic AgentsDeamino Arginine VasopressinHemostaticsTranexamic Acidblood loss reductionDesmopressintotal knee arthroplastytranexamic acid

Identifiers

PMID39958575
PMCPMC11827707

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Registered trials

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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.