Tranexamic Acid in Hip Reconstructions in Children with Cerebral Palsy: A Double-Blind Randomized Controlled Clinical Trial
Surgical treatment is indicated for hip dislocation in patients with cerebral palsy (CP), but it requires care due to the state of nutrition and associated clinical comorbidities. The use of resources that minimize blood loss and the need for blood transfusions are essential to avoid complications....
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-12-01
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| Series: | Children |
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| Online Access: | https://www.mdpi.com/2227-9067/10/12/1931 |
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| author | Alexandre Zuccon Paulo Rogério Cardozo Kanaji Dávia Serafini Barcellos Saulo Zabulon Ageu de Oliveira Saraiva Thaila Andressa Yoshi de Freitas |
| author_facet | Alexandre Zuccon Paulo Rogério Cardozo Kanaji Dávia Serafini Barcellos Saulo Zabulon Ageu de Oliveira Saraiva Thaila Andressa Yoshi de Freitas |
| author_sort | Alexandre Zuccon |
| collection | DOAJ |
| description | Surgical treatment is indicated for hip dislocation in patients with cerebral palsy (CP), but it requires care due to the state of nutrition and associated clinical comorbidities. The use of resources that minimize blood loss and the need for blood transfusions are essential to avoid complications. Tranexamic acid (TXA) has been highlighted for orthopedic surgeries to control intraoperative bleeding; however, there is a lack of large studies for its use in hip surgeries in patients with CP. This study aims to evaluate the efficacy and safety of tranexamic acid to reduce bleeding in pediatric patients with cerebral palsy undergoing surgical treatment for hip instability. A sample of 31 patients with CP who underwent surgical treatment for hip dislocation (hip adductor stretching, varization osteotomy of the proximal femur and acetabuloplasty using the Dega technique) was randomly divided into groups: control (<i>n</i> = 10) and TXA (<i>n</i> = 21). Preoperative and 24 h hemoglobin concentrations, the length of hospital stay (LHS), and intraoperative bleeding (IB) were analyzed. TXA significantly reduced the IB (<i>p</i> = 0.02). The variance in hemoglobin concentration was lower for the TXA group, but without statistical significance (<i>p</i> = 0.06). There was no difference in LHS. Also, no statistical difference was observed for the number of transfusions (<i>p</i> = 0.08). The findings provide evidence of the effectiveness of TXA in decreasing intraoperative bleeding and its safety for use in pediatric patients with cerebral palsy. |
| first_indexed | 2024-03-08T20:54:00Z |
| format | Article |
| id | doaj.art-b9f322a8c61543ce856e62b0d9696c5e |
| institution | Directory Open Access Journal |
| issn | 2227-9067 |
| language | English |
| last_indexed | 2024-03-08T20:54:00Z |
| publishDate | 2023-12-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Children |
| spelling | doaj.art-b9f322a8c61543ce856e62b0d9696c5e2023-12-22T14:00:32ZengMDPI AGChildren2227-90672023-12-011012193110.3390/children10121931Tranexamic Acid in Hip Reconstructions in Children with Cerebral Palsy: A Double-Blind Randomized Controlled Clinical TrialAlexandre Zuccon0Paulo Rogério Cardozo Kanaji1Dávia Serafini Barcellos2Saulo Zabulon3Ageu de Oliveira Saraiva4Thaila Andressa Yoshi de Freitas5Disabled Children’s Care Association of São Paulo (AACD-SP), São Paulo 04027-000, BrazilDisabled Children’s Care Association of São Paulo (AACD-SP), São Paulo 04027-000, BrazilDisabled Children’s Care Association of São Paulo (AACD-SP), São Paulo 04027-000, BrazilDisabled Children’s Care Association of São Paulo (AACD-SP), São Paulo 04027-000, BrazilDisabled Children’s Care Association of São Paulo (AACD-SP), São Paulo 04027-000, BrazilDisabled Children’s Care Association of São Paulo (AACD-SP), São Paulo 04027-000, BrazilSurgical treatment is indicated for hip dislocation in patients with cerebral palsy (CP), but it requires care due to the state of nutrition and associated clinical comorbidities. The use of resources that minimize blood loss and the need for blood transfusions are essential to avoid complications. Tranexamic acid (TXA) has been highlighted for orthopedic surgeries to control intraoperative bleeding; however, there is a lack of large studies for its use in hip surgeries in patients with CP. This study aims to evaluate the efficacy and safety of tranexamic acid to reduce bleeding in pediatric patients with cerebral palsy undergoing surgical treatment for hip instability. A sample of 31 patients with CP who underwent surgical treatment for hip dislocation (hip adductor stretching, varization osteotomy of the proximal femur and acetabuloplasty using the Dega technique) was randomly divided into groups: control (<i>n</i> = 10) and TXA (<i>n</i> = 21). Preoperative and 24 h hemoglobin concentrations, the length of hospital stay (LHS), and intraoperative bleeding (IB) were analyzed. TXA significantly reduced the IB (<i>p</i> = 0.02). The variance in hemoglobin concentration was lower for the TXA group, but without statistical significance (<i>p</i> = 0.06). There was no difference in LHS. Also, no statistical difference was observed for the number of transfusions (<i>p</i> = 0.08). The findings provide evidence of the effectiveness of TXA in decreasing intraoperative bleeding and its safety for use in pediatric patients with cerebral palsy.https://www.mdpi.com/2227-9067/10/12/1931cerebral palsyhip dislocationhip reconstructionbleedingtranexamic acid |
| spellingShingle | Alexandre Zuccon Paulo Rogério Cardozo Kanaji Dávia Serafini Barcellos Saulo Zabulon Ageu de Oliveira Saraiva Thaila Andressa Yoshi de Freitas Tranexamic Acid in Hip Reconstructions in Children with Cerebral Palsy: A Double-Blind Randomized Controlled Clinical Trial Children cerebral palsy hip dislocation hip reconstruction bleeding tranexamic acid |
| title | Tranexamic Acid in Hip Reconstructions in Children with Cerebral Palsy: A Double-Blind Randomized Controlled Clinical Trial |
| title_full | Tranexamic Acid in Hip Reconstructions in Children with Cerebral Palsy: A Double-Blind Randomized Controlled Clinical Trial |
| title_fullStr | Tranexamic Acid in Hip Reconstructions in Children with Cerebral Palsy: A Double-Blind Randomized Controlled Clinical Trial |
| title_full_unstemmed | Tranexamic Acid in Hip Reconstructions in Children with Cerebral Palsy: A Double-Blind Randomized Controlled Clinical Trial |
| title_short | Tranexamic Acid in Hip Reconstructions in Children with Cerebral Palsy: A Double-Blind Randomized Controlled Clinical Trial |
| title_sort | tranexamic acid in hip reconstructions in children with cerebral palsy a double blind randomized controlled clinical trial |
| topic | cerebral palsy hip dislocation hip reconstruction bleeding tranexamic acid |
| url | https://www.mdpi.com/2227-9067/10/12/1931 |
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