SynthesisOtolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery2026
The Effectiveness of Tranexamic Acid in Pediatric Posttonsillectomy Hemorrhage (A Systematic Review and Meta-Analysis).
Synthesis in Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery, 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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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.
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.
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0 citing papers in PubMed.
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Authors and funding
3 authors.
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No grant is acknowledged in the PubMed record.
Abstract
objectiveTo systematically review the literature regarding the effectiveness of tranexamic acid (TXA) in the management of pediatric post-tonsillectomy hemorrhage (PTH). DATA SOURCES: Comprehensive searches across PubMed, Embase, and Web of Science were conducted through December 2024 in accordance with Preferred Reporting Items for Systematic reviews and Meta-analyses (PRISMA) guidelines. REVIEW
methodsStudies evaluating TXA (any route) for PTH in children aged 2 to 18 years were reviewed. Study characteristics, patient demographics, tonsillectomy technique, postoperative day on presentation, patient exam, route of TXA administration, and dosage were extracted. The primary outcome of interest was the rate of reoperation for hemostasis; secondary outcomes of interest included need for blood transfusion and adverse effects.
resultsEight studies (n = 801) met inclusion criteria. TXA administration was associated with a significant reduction in reoperation rates for hemostasis (pooled RR = 0.62, 95% CI 0.49-0.78), with no significant difference between routes of administration. There was no statistically significant difference in transfusion risk (RR = 0.76, 95% CI 0.26-9.45). Across all studies, no adverse effects attributable to TXA were reported.
conclusionTXA use in managing pediatric PTH is associated with a significant reduction in reoperation rates, with both intravenous and nebulized formulations demonstrating similar effectiveness. Nebulized TXA offers practical advantages in pediatric patients and provides potential targeted oropharyngeal delivery. The available evidence is limited by retrospective study designs, small sample sizes, and risk of bias. These findings support the need for prospective studies to standardize assessment and treatment algorithms, optimize management, inform clinical practice guidelines. LEVEL OF EVIDENCE: 3:
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