Ácido tranexámico y tromboelastografía en revisión de remplazo total de cadera y cirugía mayor de columna

Introduction: Thromboelastography (TEG) and
antifibrinolytic drugs are useful in the diagnosis
and management of patients undergoing major or-
thopedic surgery to reduce perioperative bleeding
and transfusion requirement. We described the
effect of tranexamic acid on thromboelastography
parameters. Methods: In 20 patients undergoing
major orthopedic surgery, a dose of 20 mg/kg tra-
nexamic acid followed infusion 1 mg/kg/h until
the end of the procedure was administered. Two
TEG were performed; baseline and a control at
the end of the procedure. Thromboelastography
effects are described. Results and Conclusions:
No fibrinolysis was observed in the samples taken,
however in 75% of patients increased the alpha
angle suggesting a higher speed in clot forma-
tion; which might suggest a different mechanism
of action of Tranexamic Acid as pro coagulant.
Factors such as gender and age may modify the
baseline TEG. The surgical time and the type of
surgery are critical in bleeding and blood product
requirement.