ArticleInternational journal of cardiology. Heart & vasculature2026
Combining topical and intravenous tranexamic acid in cardiac surgery: does it really matter? - a systematic review and meta-analysis.
Article in International journal of cardiology. Heart & vasculature, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: The benefit-to-risk ratio of administration of intravenous (IV) and topical tranexamic acid (TXA) together in cardiac surgery has not yet been determined. This study aims to evaluate whether the combined approach (IV plus topical TXA) offers superior bleeding control compared to IV TXA alone, while maintaining an acceptable safety profile. Methods: We conducted a systematic review and Results: We included a total of five studies (four RCTs, one observational; n = 880). Pooled analysis showed that the combined approach significantly, but modest, reduced total blood loss when compared to an IV-only TXA strategy (MD -39.84, 95 %CI -74.80 to -4.88; p = 0.03; I Conclusion: Combined topical and IV TXA application is associated with reduced total blood loss after cardiac surgery compared to an IV-only approach. However, no significant differences were observed in transfusion rates, blood product utilization, or mortality.
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