Efectividad y seguridad de ácido tranexámico en pacientes quirúrgicos no ortopédicos. Revisión sistemática
Carrillo Ávila, Diego Leonardo
Ramos Hernández, Anamaría
Objectives: To evaluate the effectiveness and safety of the use of tranexamic acid administered intravenously for the control of bleeding in patients undergoing elective and emergency surgery in non-orthopedic contexts. Methodology: Systematic review of the literature according to the methodology of the Cochrane Collaboration and the recommendations of the PRISMA statement. Articles between 2011 and 2018 were included from the Medline, Embase, Central, Web of Science, Lilacs, mRCT and Who International Trials Registry Platforms databases in Spanish, English, Portuguese and French. Results: 35 randomized trials were included. The use of tranexamic acid was related to the decrease of bleeding in the elective cesarean sections in 225.52cc 95% CI (216.04 - 235.01) and in myocardial revascularization in 170.51 cc 95% CI (138.4 - 202.62), however, there was statistical heterogeneity between the studies. The other reported interventions where decreased bleeding was found included otorhinolaryngology, maxillofacial, gynecology and urology surgeries. In the oncological procedures no benefit was found, which can be explained by the comorbidity. Adverse effects related to the use of tranexamic acid were reported in the studies descriptively in most of the studies. The same happened with the outcome of mortality or was not considered. Conclusions: The use of intravenous tranexamic acid in non-orthopedic surgeries decreases the volume of intraoperative bleeding. The safety of the use of the medication is not yet clear, there is a lack of information in the results of studies where tranexamic acid is used as an intervention.