The effect of tranexamic acid on intraoperative blood loss in patients undergoing brain meningioma resections: Study protocol for a randomized controlled trial

• Published in: PloS one Vol. 18; no. 8; p. e0290725
• Main Authors: Yu, Haojie, Liu, Minying, Zhang, Xingyue, Ma, Tingting, Yang, Jingchao, Wu, Yaru, Wang, Jie, Li, Muhan, Wang, Juan, Zeng, Min, Zhang, Liyong, Jin, Hailong, Liu, Xiaoyuan, Li, Shu, Peng, Yuming
• Format: Journal Article
• Language: English
• Published: San Francisco Public Library of Science 31.08.2023; Public Library of Science (PLoS)
• Subjects: Anesthesia; Antifibrinolytic agents; Biology and Life Sciences; Birth defects; Bleeding; Blood coagulation; Blood pressure; Blood transfusion; Blood volume; Brain cancer; Brain research; Care and treatment; Clinical trials; Coagulation; Complications and side effects; Drug therapy; Embolization; Hemorrhage; Hospitals; Mathematical analysis; Medical personnel; Medicine and Health Sciences; Meningioma; Neurosurgery; Patient outcomes; Study Protocol; Suction; Surgery; Thrombolysis; Thrombolytic drugs; Tranexamic acid; Ventilation; Ventilators; China; Beijing China
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0290725

Tranexamic acid (TXA) has been proven to prevent thrombolysis and reduce bleeding and blood transfusion requirements in various surgical settings. However, the optimal dose of TXA that effectively reduce intraoperative bleeding and blood product infusion in patients undergoing neurosurgical resection of meningioma with a diameter [greater than or equal to] 5 cm remains unclear. This is a single-center, randomized, double-blinded, paralleled-group controlled trial. Patients scheduled to receive elective tumor resection with meningioma diameter [greater than or equal to] 5 cm will be randomly assigned the high-dose TXA group, the low-dose group, and the placebo. Patients in the high-dose TXA group will be administered with a loading dose of 20 mg/kg TXA followed by continuous infusion TXA at a rate of 5 mg/kg/h. In the low-dose group, patients will receive the same loading dose of TXA followed by a continuous infusion of normal saline. In the control group, patients will receive an identical volume of normal saline. The primary outcome is the estimated intraoperative blood loss calculated using the following formula: collected blood volume in the suction canister (mL)-the volume of flushing (mL) + the volume from the gauze tampon (mL). Secondary outcomes include calculated intraoperative blood loss, intraoperative coagulation function assessed using thromboelastogram (TEG), intraoperative cell salvage use, blood product infusion, and other safety outcomes. Preclinical studies suggest that TXA could reduce intraoperative blood loss, yet the optimal dose was controversial. This study is one of the early studies to evaluate the impact of intraoperative different doses infusion of TXA on reducing blood loss in neurological meningioma patients.