Impact of Tranexamic Acid in Total Knee and Total Hip Replacement.
Aged; Antifibrinolytic Agents/adverse effects/therapeutic use; Arthroplasty; Blood Transfusion; Blood Transfusion/statistics & numerical data; Case-Control Studies; Descriptive Statistics; Female; Hemoglobins – Analysis; Hemoglobins/metabolism; Hip; Hip/*methods; Human; Humans; Knee; Knee/*methods; Length of Stay – Evaluation; Length of Stay/statistics & numerical data; Male; Outcome Assessment; Replacement; Retrospective Design; Retrospective Studies; total hip replacement; total knee replacement; tranexamic acid; Tranexamic Acid – Administration and Dosage; Tranexamic Acid/adverse effects/*therapeutic use; Venous Thromboembolism – Risk Factors; Venous Thromboembolism/epidemiology
OBJECTIVE: To evaluate the net clinical benefit of tranexamic acid use in patients undergoing total knee or total hip replacement. METHODS: This is a retrospective study of patients undergoing total knee or total hip replacement. The primary outcome was the net clinical benefit of tranexamic acid use. Secondary outcomes included length of stay, incidence of venous thromboembolism, change in hemoglobin, and number of units of blood transfused. RESULTS: Four hundred and six patients were screened for inclusion and 327 patients met inclusion criteria; 174 patients received tranexamic acid versus 153 patients who received usual care. Tranexamic acid demonstrated a positive net clinical benefit versus usual care (40.8% vs 13.7%, P \textless .01) but did not affect length of stay (3.39 vs 3.37 days, respectively, P = .76). Venous thromboembolism was comparable between groups (2.3% vs 0.7%, P = .38). Average change in hemoglobin and need for transfusion were lower in the treatment group versus the usual care group, respectively (3.46 vs 4.26 mg/dL, P \textless .01). CONCLUSION: Tranexamic acid demonstrated a significant benefit in decreasing change in hemoglobin as well as the need for blood transfusion with no increase in the risk of venous thromboembolism in patients undergoing total knee or total hip replacement.
Boyle Jaclyn A; Soric Mate M
Journal of pharmacy practice
2017
2017-02
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1177/0897190015621813" target="_blank" rel="noreferrer noopener">10.1177/0897190015621813</a>
Body mass index moderates the effects of portable oxygen transport modality on
*Oxygen Inhalation Therapy/instrumentation/methods; *Pulmonary Disease; *Quality of Life; Activities of Daily Living; Aged; Body Mass Index; Chronic Obstructive – Diagnosis; Chronic Obstructive – Metabolism; Chronic Obstructive – Physiopathology; Chronic Obstructive – Psychosocial Factors; Chronic Obstructive – Therapy; Chronic Obstructive/diagnosis/metabolism/physiopathology/psychology/therapy; Drug Delivery Systems – Methods; Drug Delivery Systems – Standards; Drug Delivery Systems/methods/standards; Exercise Test – Methods; Exercise Test/methods; Exertion; Female; Heart Rate; Hemoglobins – Analysis; Human; Humans; Male; Middle Age; Middle Aged; Outcome Assessment; Outcome Assessment (Health Care); Oxygen Consumption; Oxygen Therapy – Equipment and Supplies; Oxygen Therapy – Methods; Oxyhemoglobins/analysis; Physical Exertion; Pulmonary Disease; Quality of Life; Walking – Physiology; Walking/*physiology
PURPOSE: While portable, supplemental oxygen is often necessary for patients with chronic obstructive pulmonary disease (COPD) to retain independence, it may provide functional limitations because of the increased workload imposed. This issue may result in nonuse, creating a need to identify carrying modalities that optimize transport. This study assessed the effects of 3 methods of portable oxygen transport on 6-minute walk distance (6 MWD), rate of perceived exertion (RPE), heart rate (HR), and oxyhemoglobin saturation (SpO2). As weight status is known to impact functional ability in COPD, effects of body mass index (BMI) were also assessed. METHODS: Data were analyzed using the mixed-model procedure to test for effects of transport modality (reference, rolling cart, backpack, shoulderstrap), time (minutes 1-6), BMI, non-overweight, overweight, and interactions of these variables on outcome parameters. RESULTS: A main effect of condition was found for 6 MWD, and an interaction of condition x BMI was found for HR and RPE, and of time x BMI for 6 MWD and SpO2. Participants walked the least distance in rolling cart condition, which was also characterized by the greatest RPE. For the overweight group, HR was least in the reference compared with other conditions; but for the non-overweight group, the opposite pattern was observed. At latter time points, 6 MWD was greater in the non-overweight group, while SpO2 was reduced. CONCLUSION: Results demonstrate that transport modality of portable oxygen exerts differential effects on functional performance in COPD patients and that BMI may moderate underlying physiologic factors that contribute to performance outcomes.
Pohle-Krauza Rachael J; McCarroll Michele L; Pannikottu Kurian; Latta Tiffany N; DiNuoscio David R; Volsko Teresa A; Gothard M David; Krauza Matthew L
Journal of cardiopulmonary rehabilitation and prevention
2014
2014-02
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1097/HCR.0000000000000035" target="_blank" rel="noreferrer noopener">10.1097/HCR.0000000000000035</a>