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Z Orthop Unfall 2023; 161(05): 532-537
DOI: 10.1055/a-2055-8178
Übersicht

The Perioperative Application of Tranexamic Acid

Recommendation of the Working Group Endoprosthetics in Cooperation with an Expert Group of the German Society for Anesthesiology and Intensive Care Medicine Update February 2023 Article in several languages: deutsch | English
Carsten Perka
1   Klinik für Orthopädie, Centrum für Muskuloskeletale Chirurgie, Charité - Universitätsmedizin Berlin, Berlin, Deutschland (Ringgold ID: RIN14903)
,
Christian von Heymann
2   Klinik für Anästhesie, Intensivmedizin, Notfallmedizin und Schmerztherapie, Vivantes Klinikum im Friedrichshain, Berlin, Berlin, Deutschland
,
Heiko Lier
3   Klinik für Anästhesiologie und Operative Intensivmedizin, Medizinische Fakultät und Uniklinik Köln, Köln, Deutschland
,
Lutz Kaufner
4   Klinik für Anästhesiologie mit Schwerpunkt operative Intensivmedizin, Charité ‒ Universitätsmedizin Berlin, Berlin, Deutschland (Ringgold ID: RIN14903)
,
Sascha Treskatsch
4   Klinik für Anästhesiologie mit Schwerpunkt operative Intensivmedizin, Charité ‒ Universitätsmedizin Berlin, Berlin, Deutschland (Ringgold ID: RIN14903)
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Zusammenfassung

Der Einsatz von Tranexamsäure (TXA) hat in den letzten Jahren bei der Durchführung endoprothetischer Operationen stark zugenommen. Die Möglichkeit, den Blutverlust zu reduzieren, die Zahl der Transfusionen zu vermindern und meist auf Drainagen zu verzichten, lassen den Einsatz von TXA immer mehr als „Standard“ erscheinen. Andererseits besteht keine Zulassung von TXA für den Einsatz bei endoprothetischen Eingriffen. Aus diesem Grund sollte unbedingt immer einen Nutzen-Risiko-Analyse erfolgen. Eine prophylaktische TXA-Gabe ohne Aufklärung ist daher gerechtfertigt, wenn eine fibrinolysebedingte Blutung zu erwarten ist und keine Kontraindikationen oder Risikofaktoren für thromboembolische Komplikationen vorliegen. Eine Aufklärung ist auch nicht erforderlich, wenn im Rahmen einer fibrinolysebedingten Blutung eine therapeutische TXA-Gabe erfolgt. Der nach gegenwärtigem Kenntnisstand optimale Zeitpunkt, die möglichen Applikationswege und die Dosierungsempfehlungen werden in der vorliegenden Handlungsempfehlung dargestellt.

Schlüsselwörter

Tranexamsäure - Fibrinolyse - Hyperfibrinolyse - Blutverlust


Publication History

Article published online:
19 June 2023

© 2023. Thieme. All rights reserved.

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