Which route of administration of acid tranexamic, intravenous or intra-articular, is more effective in the control of post-surgical bleeding after a total hip arthroplasty? A prospective, controlled and randomized study | Revista Española de Cirugía Ortopédica y Traumatología (English Edition)

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"apellidos" => "Rodrigo Pérez" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "a" "identificador" => "aff0005" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Servicio de Cirugía Ortopédica y Traumatología, Hospital Universitario Doctor Peset, Valencia, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Área de Medicina Preventiva y Salud Pública, Epidemiología, Universidad de Valencia, Valencia, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Aplicación del tranexámico intravenoso o intraarticular en el control del sangrado posquirúrgico tras una artroplastia total de cadera. Estudio prospectivo, controlado y aleatorizado" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 2019 "Ancho" => 2342 "Tamanyo" => 275413 ] ] "descripcion" => array:1 [ "en" => "Consolidated Standards of Reporting Trials (CONSORT). Diagram for the study." ] ] ] "textoCompleto" => "IntroductionTotal hip arthroscopy is one of the most common interventions in the treatment of osteoarticular hip pain secondary to arthrosis or avascular necrosis of the femoral head. One of the most frequent complications of surgery is large-scale intraoperative bleeding that will continue postoperatively. Previous studies have shown ranges of blood loss from 1.188ml to 1.651ml.<a class="elsevierStyleCrossRefs" href="#bib0150">1,2</a> Furthermore, it has been observed that between 10% and 38% of patients undergoing arthroplasty require an average 2units of packed erythrocytes to minimise the haemoglobin and haematocrit drop.<a class="elsevierStyleCrossRefs" href="#bib0160">3,4</a> No allogenic blood transfusion is risk-free, and in addition to adding to costs, it significantly increases complications: postoperative infections, hospital stay, mortality or delayed physical recovery, for example.<a class="elsevierStyleCrossRef" href="#bib0170">5</a>Many strategies have been deployed to reduce postoperative bleeding and the number of transfusions after prosthetic surgery, including autologous donation, intraoperative controlled hypotension, regional anaesthesia, blood saving measures, erythropoietin and antifibrinolytic agents. Tranexamic acid (TXA), marketed as Amchafibrin® is the most powerful and has the fewest complications of the antifibrinolytic agents. Its administration inhibits the activation of plasminogen to plasmin, through blocking the lysine binding site, and prevents fibrin degradation.<a class="elsevierStyleCrossRefs" href="#bib0175">6,7</a>Previous orthopaedic and cardiovascular surgery studies have demonstrated that TXA reduces postoperative bleeding and the amount of allogenic transfusions compared to a control group using routine haemostasis.<a class="elsevierStyleCrossRefs" href="#bib0180">7,8</a> Moreover, it did not increase the number of thromboembolic events, or surgical infections.<a class="elsevierStyleCrossRefs" href="#bib0165">4,9</a> However, most of these prospective, randomized or meta-analysis studies have focussed on the effectiveness, efficacy and safety of tranexamic acid without specifying the optimal administration route.<a class="elsevierStyleCrossRefs" href="#bib0195">10–12</a> Recently the benefits of topical administration of TXA have been published, delivering a maximum concentration to the surgical site with low systemic effect.<a class="elsevierStyleCrossRef" href="#bib0195">10</a> Therefore, we consider it necessary to undertake a study to clarify which administration route, topical or intravenous, is superior and equally safe in reducing postoperative bleeding after a primary hip arthroplasty. To that end we evaluated two independent parameters, the volume of blood drained and total blood loss, taking into account the need for transfusions. We presumed that the topical application (intra-articular) of TXA after closure would reduce postoperative bleeding and help maintain haemodynamic stability as well as its intravenous use. Our secondary aim was to analyse whether either of the administration routes reduced the number of allogenic blood transfusions and the incidence of possible thromboembolic events more than the other.Material and methodDesignWe undertook a prospective and randomized, two-arm, phase IV clinical trial in the Doctor Peset University Hospital of Valencia after approval from the clinical research ethics committee. Group A (arm A) were given 15mg/kg of TXA intravenously 15–20min before the end of the surgical intervention. Group B (arm B) received 2 grams of intra-articular TXA in 100ml of saline via the Redon drain, once the wound had been closed; the Redon drain was then clamped for 2h.The dose of TXA we used was based on previous studies according to routine clinical practice.<a class="elsevierStyleCrossRefs" href="#bib0210">13,14</a>We did not require a control group, because there is already sufficient published literature demonstrating the usefulness and safety of TXA as an antifibrinolytic agent to reduce postoperative bleeding, which is already marketed as Amchafibrin®.Study population and sample sizeThe study was performed on patients who underwent elective total hip arthroplasty due to coxarthrosis or avascular necrosis in the period between February 2017 and February 2018.Given that at the time of starting the study there were no publications describing differences in the use of intravenous or intra-articular TXA after a total hip prosthesis, we used a time criterion to calculate the sample size.All the patients who met the inclusion criteria were consecutively randomized by intervention demand into 2 groups or arms, group A, who received intravenous treatment with TXA plus routine haemostasis, and group B, who received intra-articular treatment plus routine haemostatis. During the study the orthopaedic surgeon and the anaesthetist were not blinded due to the different tranexamic acid administration routes. However, the entire subsequent follow-up was undertaken homogeneously and in a standardised way for the 2 groups.Selection criteriaInclusion criteriaAll patients aged between 18 and 85 who had undergone a total hip replacement due to primary coxarthrosis or avascular necrosis were included in the study. The patients had to have signed their informed consent for the surgical intervention and to take part in the study, and have a recent lab test result confirming normality of platelet count, INR and prothrombin time.Exclusion criteriaAll patients who were allergic to tranexamic acid, those who refused to participate in the study, those with a secondary arthropathy (rheumatoid arthritis, post-traumatic arthritis, psoriatic arthritis), cardiovascular disease (acute myocardial infarction, atrial fibrillation, angina, grade 3–4 heart failure, prior heart surgery), cerebrovascular disease (stroke, transient ischaemic attack and vascular surgery, thromboembolic disease (deep vein thrombosis [DVT], fibrinolysis disorders and coagulopathies (if INR>1.4, platelets<150,000×109/l, prothrombin time>1.4), liver and/or kidney failure, treatment with anticoagulants 7 days prior to the surgical intervention, blood product rejection, intraoperative complications (anaesthetic or surgical), those participating in another clinical trial, and with preoperative haemoglobin levels<12g/dl were excluded from the study.Variables studiedThe patients’ sociodemographic variables were collected (age at the time of the intervention, sex, weight, height and body mass index), medical history, preanaesthetic assessment and variables relative to the intervention (such as the type of anaesthesia used, approach, surgical time, days of hospital stay and laterality). The main clinical variables collected were preoperative and postoperative haemoglobin and haematocrit (at 24h and 72h), the lowest haemoglobin recorded during the hospital stay, the patient's blood volume (<a class="elsevierStyleCrossRef" href="#sec0090">Annex 1</a>), total blood loss (<a class="elsevierStyleCrossRef" href="#sec0095">Annex 2</a>), hidden blood loss (<a class="elsevierStyleCrossRef" href="#sec0100">Annex 3</a>), and the drainage volume at 24 and 48h (ml). In addition, the number of blood units transfused and the complications from the intervention (the wound developing infection or necrosis, DVT, PTE or death) were gathered as secondary variables.The centre's surgical protocolAll the interventions were performed by a team of orthopaedic surgeons with experience in primary hip arthroplasty. All the patients received cementless models.In the anaesthetic induction intravenous antibiotic prophylaxis was administered according to the hospital's infections committee. During the entire operation haemostatis was undertaken using electrocoagulation of the blood vessels. After the intervention we placed a number 12 vacuum drain, which was removed after 48h. The topical TXA (group B) was inserted via the Redon drain, once the wound had been closed, which was then clamped for 2h. The Redon drains of the patients receiving intravenous TXA (group A) were opened after placing the compression bandage. Six hours after the surgical intervention the patients received venous thromboembolism prophylaxis with low molecular weight bemiparin, which was maintained for 30 days.All the patients who were admitted followed the same blood transfusion protocol based on the perioperative transfusion guidelines of the National Institutes of Health Consensus Conference.<a class="elsevierStyleCrossRef" href="#bib0220">15</a> Red blood cell transfusion was indicated should the patient's haemoglobin levels fall below 8g/dl, or below 10g/dl if they had associated cardiopulmonary disease and symptoms of anaemia, defined as syncope, fatigue, palpitations or dizziness.Any complications such as thromboembolic events were noted and collected throughout the patients’ hospital stay. On discharge, all the patients were given outpatient appointments 3 weeks after the intervention, when any possible complications were assessed.Data collectionThe patient data collection was undertaken homogeneously and in a standardised way for the 2 groups. The data were collectively postoperatively by a different team of surgeons. The haemoglobin levels and haematocrit at 24 and 72h following the surgery, the daily drained blood volumes, whether or not a blood transfusion had been given, and a series of the abovementioned demographic variables were recorded. In this assessment phase the analysis was blinded. In addition, confusion bias was avoided since these were objective results.Statistical analysisFirstly a descriptive analysis was undertaken where normally distributed continuous variables were described as mean±standard deviation (SD), and those that were not normally distributed, or non-Gaussian, were described as median (maximum–minimum). The qualitative variables were described in frequencies and percentages. The Kolmogorov–Smirnov test was used to check the variables’ normality distribution. The χ2 test was used to study the association between qualitative variables. The Student's t-test, Mann–Whitney U test or ANOVA were used to study the differences between means according to the application conditions. Differences with p<.05 were considered statistically significant in all the tests. The computer analysis was performed using SPSS 22.0.Ethical aspectsThis paper was completed after the approval of the Doctor Peset University Hospital's ethics committee, in compliance with the recommendations of the 1964 Declaration of Helsinki. All the patients included in the study signed their informed consent.ResultsBetween February 2017 and February 2018, 90 patients scheduled for primary hip arthroscopy were included in the study. Of this initial group, 12 patients were excluded from the study, 8 because they did not meet the inclusion criteria, 3 because they did not want to participate, and one case was excluded during the follow-up when an iatrogenic fracture was confirmed that required intraoperative transfusions. The final analysis was undertaken on 78 patients, of whom 31 were randomized to group A and received the intravenous treatment, and 47 patients to group B who received intra-articular TXA (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>).<elsevierMultimedia ident="fig0005"></elsevierMultimedia>No significant differences were found in terms of age, sex, body mass index or American Society of Anesthesiologists’ classification<a class="elsevierStyleCrossRef" href="#bib0225">16</a> (<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>). The comorbidity associated with the surgical intervention was gathered and assessed; chronic diseases such as arterial hypertension, diabetes mellitus and dyslipaemia under treatment were found in 66.66% of the patients (52 cases).<elsevierMultimedia ident="tbl0005"></elsevierMultimedia>The preoperative haemoglobin levels and haematocrit were similar in both groups. The fall in haemoglobin and mean haematocrit after the intervention was also similar. In group A, who received intravenous TXA, we started with a mean preoperative Hb of 14.28g/dl, with a mean fall at 24h of 3.15±1.64g/dl, and of 3.75±1.56g/dl at 72h. The haematocrit suffered a mean drop of 10.4±4.17% at 24h, and of 11.85±4.15% at 72h. In group B, with the intra-articular administration, we started with a mean Hb of 14.23g/dl, and a mean fall of 3.03±1.30g/dl was observed at 24h, and of 3.22±1.2g/dl at 72h. The haematocrit dropped 10.66±3.6% and 12.11±3.29% at 24 and 72h respectively. The lowest recorded mean haemoglobin levels were 10.3g/dl for group A, and 10.8g/dl for group B. We found no significant differences between either group in any of the values studied (<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>).<elsevierMultimedia ident="tbl0010"></elsevierMultimedia>The mean drainage values in the first 24h were 195.80ml in group A with intravenous administration compared to 253.93ml collected from group B, with the intra-articular administration. At 48h, prior to removing the drain, a mean drainage of 225.33ml was recorded for group A compared to the 328.19ml of group B; there was a statistically significant association (p=.009) in the values collected at 48h. If we analyse the patient's blood volume and calculate the total blood loss after the surgery we see that the intravenous group lost 1505.42±499.32ml, while the intra-articular group lost 1280.00±352.89ml, showing a statistically significant association (p=.022).The proportion of patients who required a transfusion was 9.7% in group A, whereas in group B 2.1% of the cases received a transfusion.The surgery time and mean hospital stay were similar in both groups, with no statistically significant association (<a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>).<elsevierMultimedia ident="tbl0015"></elsevierMultimedia>In terms of complications, of a total 78 operated patients, we only had 4 cases with complications (2 calcar fractures, one case of symptoms of allergic reaction to bemiparin and one surgical infection). No thromboembolic complications or complications secondary to the TXA administration route were found in the immediate postoperative period or in the follow-up (<a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>).DiscussionTotal hip arthroplasty involves significant intra- and postoperative blood loss. The onset of postsurgical anaemia can increase mortality and morbidity, increase length of hospital stay and delay rehabilitation.<a class="elsevierStyleCrossRef" href="#bib0230">17</a> Different processes have been developed over many years in order to minimise blood loss, and thus prevent allogenic blood transfusion, an invasive technique associated with major complications.<a class="elsevierStyleCrossRef" href="#bib0155">2</a> Many studies report the benefits of tranexamic acid in reducing postoperative bleeding.<a class="elsevierStyleCrossRefs" href="#bib0185">8,18,19</a> There has been increasing interest in the topical administration of TXA in recent years due to its direct application to the surgical site with local action which minimises systemic side effects.<a class="elsevierStyleCrossRefs" href="#bib0195">10,20,21</a> When tranexamic acid is given intravenously it distributes intracellularly and extracellularly until it reaches its maximum concentration after 5–15min, increasing its risk of causing thromboembolic complications.<a class="elsevierStyleCrossRefs" href="#bib0195">10,22,23</a> In our randomized clinical trial we demonstrated that there are no statistically significant differences in the topical administration of 2g of tranexamic acid compared to the standard treatment of 15mg/kg intravenously, in terms of falls in haemoglobin and haematocrit, blood loss and the need for transfusions. In a recently published meta-analysis similar results to ours were obtained in terms of reduced bleeding and minimising transfusions.<a class="elsevierStyleCrossRef" href="#bib0260">23</a> However, unlike our results, they observed less of a fall in haemoglobin in the intravenous group, without being able to ensure the superiority of this route; probably due to insufficient data.Many studies have demonstrated that the intra-articular route is not inferior to the standard intravenous administration after a total knee arthroplasty,<a class="elsevierStyleCrossRefs" href="#bib0165">4,12–14</a> some authors even recommend intra-articular administration as more effective, since it is a direct and simple route that can be used for patients for whom the systemic use of TXA is contraindicated, since its absorption from the joint is not very clinically significant.<a class="elsevierStyleCrossRef" href="#bib0265">24</a> We found few publications on the hip that refer to statistically significant differences in decreased bleeding according to the administration route, and the few we did find defend the intravenous route.<a class="elsevierStyleCrossRefs" href="#bib0270">25,26</a> Our study found very similar results, but always with less total blood loss and lower falls in haemoglobin in the intra-articular group, and there was a statistically significant association in some values. Likewise, the patients in the intra-articular administration group received fewer transfusions compared to the intravenous group, and although we did not obtain a statistically significant result and we cannot confirm the superiority of one route over the other, this constant tendency towards better results using the intra-articular route has encouraged us to use it in our clinical practice.The administration of tranexamic acid has proved a safe technique, since we have had no increase in complications (PTE, DVT or deep infections). Only one patient in group B developed a seroma that required surgical cleaning and intravenous antibiotic therapy for 7 days. However, most authors recommend the topical route for patients with a potential risk of thromboembolic events.<a class="elsevierStyleCrossRef" href="#bib0260">23</a>Most publications make no mention of surgery time,<a class="elsevierStyleCrossRef" href="#bib0235">18</a> therefore they consider that it might influence blood loss. In our study we assessed the surgery time of the intravenous group (109.35±25.01min) compared to the topical group (103.6±18.9min), and found no statistically significant differences.This study has some limitations. Firstly, we used sequential randomisation excluding patients with major cardiovascular comorbidities, i.e., potentially thromboembolic patients. Furthermore, the number of cases allocated to each group was not equal, and was too small to be able to demonstrate a statistically significant association. Different surgeons participated which might have led to unequal intraoperative bleeding. We excluded patients who required intraoperative blood transfusions to prevent potential biases in monitoring a population with no intraoperative complications. And finally, in our hospital we do not perform routine screening for PTE or DVT, and therefore only Doppler ultrasonography was indicated in the event of clinical suspicion. Any complications might have been underestimated if there had been any asymptomatic thromboembolic events. The strengths of this paper are that it was a prospective, randomized study with team of doctors, surgical nurses and operating theatre that follow a rigorous protocol of action and data collection.The doses of tranexamic acid that should be prescribed are still a matter of controversy. Studies on the dose regimens are very heterogeneous, and probably require larger samples to obtain valid results. Our study used 15mg/kg intravenously and 2g via the intra-articular route; our doses were based on similar regimens recommended in Ref.<a class="elsevierStyleCrossRef" href="#bib0230">17</a>ConclusionThe different administration routes for tranexamic acid that we studied for primary total hip arthroplasty (topical intra-articular versus intravenous) have a similar effect in reducing postoperative bleeding. We found no increase in complications with either of the 2 established regimens. However, we prefer the intra-articular route for patients with a thromboembolic risk. Further studies are required with a larger number of cases to establish the optimal dose of tranexamic acid.Level of evidenceLevel of evidence II.Conflict of interestsThe authors have no conflict of interest to declare." "textoCompletoSecciones" => array:1 [ "secciones" => array:12 [ 0 => array:3 [ "identificador" => "xres1217639" "titulo" => "Abstract" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Introduction" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Material and method" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Conclusions" ] ] ] 1 => array:2 [ "identificador" => "xpalclavsec1133024" "titulo" => "Keywords" ] 2 => array:3 [ "identificador" => "xres1217638" "titulo" => "Resumen" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0025" "titulo" => "Introducción" ] 1 => array:2 [ "identificador" => "abst0030" "titulo" => "Material y método" ] 2 => array:2 [ "identificador" => "abst0035" "titulo" => "Resultados" ] 3 => array:2 [ "identificador" => "abst0040" "titulo" => "Conclusiones" ] ] ] 3 => array:2 [ "identificador" => "xpalclavsec1133025" "titulo" => "Palabras clave" ] 4 => array:2 [ "identificador" => "sec0005" "titulo" => "Introduction" ] 5 => array:3 [ "identificador" => "sec0010" "titulo" => "Material and method" "secciones" => array:8 [ 0 => array:2 [ "identificador" => "sec0015" "titulo" => "Design" ] 1 => array:2 [ "identificador" => "sec0020" "titulo" => "Study population and sample size" ] 2 => array:3 [ "identificador" => "sec0025" "titulo" => "Selection criteria" "secciones" => array:2 [ 0 => array:2 [ "identificador" => "sec0030" "titulo" => "Inclusion criteria" ] 1 => array:2 [ "identificador" => "sec0035" "titulo" => "Exclusion criteria" ] ] ] 3 => array:2 [ "identificador" => "sec0040" "titulo" => "Variables studied" ] 4 => array:2 [ "identificador" => "sec0045" "titulo" => "The centre's surgical protocol" ] 5 => array:2 [ "identificador" => "sec0050" "titulo" => "Data collection" ] 6 => array:2 [ "identificador" => "sec0055" "titulo" => "Statistical analysis" ] 7 => array:2 [ "identificador" => "sec0060" "titulo" => "Ethical aspects" ] ] ] 6 => array:2 [ "identificador" => "sec0065" "titulo" => "Results" ] 7 => array:2 [ "identificador" => "sec0070" "titulo" => "Discussion" ] 8 => array:2 [ "identificador" => "sec0075" "titulo" => "Conclusion" ] 9 => array:2 [ "identificador" => "sec0080" "titulo" => "Level of evidence" ] 10 => array:2 [ "identificador" => "sec0085" "titulo" => "Conflict of interests" ] 11 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2018-03-12" "fechaAceptado" => "2018-05-03" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec1133024" "palabras" => array:5 [ 0 => "Tranexamic acid" 1 => "Intravenous administration" 2 => "Intra-articular administration" 3 => "Total hip arthroplasty" 4 => "Transfusion" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec1133025" "palabras" => array:5 [ 0 => "Ácido tranexámico" 1 => "Vía intravenosa" 2 => "Vía intraarticular" 3 => "Artroplasia total de cadera" 4 => "Transfusión" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:3 [ "titulo" => "Abstract" "resumen" => "IntroductionOne of the most frequent complications after a total hip arthroplasty (THA) is bleeding, intravenous tranexamic acid (TXA) is used to reduce it. We considered it necessary to carry out a study to clarify which administration route is superior. Material and methodProspective, controlled and randomized study in 2 arms carried out between February 2017 and February 2018. 15mg/kg of intravenous TXA were administered in group A and 2g of intra-articular TXA in group B. The values of haemoglobin and haematocrit were evaluated at 24h-72h, blood loss volume, drained blood volume, transfusions and complications. Results78 patients were included, 31 with intravenous treatment and 47 with intra-articular. The decrease of haemoglobin in the intravenous group was 3.15±1.64g/dl in 24h and 3.75±1.56g/dl in 72h, the haematocrit decreased by 10.4±4.17% in 24h and 11.85±4.15% in 72h. In the intra-articular group there was a haemoglobin fall of 3.03±1.30g/dl in 24h and 3.22±1.2g/dl in 72h and the haematocrit fell by 10.66±3.6% and 12.11±3.29% in 24 and 72h (p>.05). The mean drainage in 24h was 195.80ml in group A versus 253.93ml in group B (p>.05) and in 48h it was 225.33ml in group A and 328.19ml in group B (p=.009). The intravenous group lost an average of 1505ml of blood compared to the 11,280ml of the intra-articular group. In 5.1% of the cases, transfusions were necessary. We had no secondary complications. ConclusionsThe different routes of administration of TXA in THA have a similar effect in the reduction of postoperative bleeding. There was no evidence of an increase in complications." "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Introduction" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Material and method" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Conclusions" ] ] ] "es" => array:3 [ "titulo" => "Resumen" "resumen" => "IntroducciónUna complicación frecuente tras una artroplastia total de cadera es el sangrado, y para reducirlo se utiliza el ácido tranexámico (TXA) intravenoso. Recientemente se han publicado los beneficios de su aplicación tópica. Consideramos necesario realizar un estudio que justifique qué vía de administración resulta superior. Material y métodoEstudio prospectivo, controlado, aleatorizado en 2 brazos realizado entre febrero de 2017 a febrero de 2018. En el grupo A se administró 15mg/kg TXA intravenoso y en el B 2g TXA intraarticular. Se evaluó los valores de hemoglobina y hematocrito a las 24-72horas, volumen de sangre drenado, volumen de sangre perdida, transfusiones y complicaciones. ResultadosFueron incluidos 78 pacientes, 31 con tratamiento intravenoso y 47 intraarticular. La hemoglobina descendió 3,15±1,64g/dl en 24horas y 3,75±1,56g/dl en 72horas en el grupo intravenoso, el hematocrito descendió un 10,4%±4,17% en 24horas y 11,85%±4,15% en 72horas. En el intraarticular se observó una caída de hemoglobina de 3,03±1,30g/dl en 24horas y de 3,22±1,2g/dl en 72horas y el hematocrito descendió 10,66%±3,6% y 12,11%±3,29% en 24 y 72horas (p>0,05). El drenaje medio en 24horas fue 195,80ml en el grupo A frente a 253,93ml en el grupo B (p>0,05) y a las 48horas 225,33ml en el grupo A y de 328,19ml en el grupo-B (p=0,009). En el grupo intravenoso perdieron una media de 1.505ml de sangre frente a 1.280ml del grupo intraarticular. Fueron necesarias un 5,1% de transfusiones. No tuvimos complicaciones secundarias. ConclusionesLas diferentes vías de administración del TXA en la artroplastia total de cadera tienen un efecto similar en la reducción del sangrado postoperatorio sin evidenciar un incremento de complicaciones." "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0025" "titulo" => "Introducción" ] 1 => array:2 [ "identificador" => "abst0030" "titulo" => "Material y método" ] 2 => array:2 [ "identificador" => "abst0035" "titulo" => "Resultados" ] 3 => array:2 [ "identificador" => "abst0040" "titulo" => "Conclusiones" ] ] ] ] "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "Please cite this article as: Gómez Barbero P, Gómez Aparicio MS, Blas Dobón JA, Pelayo de Tomás JM, Morales Suárez-Varela M, Rodrigo Pérez JL. Aplicación del tranexámico intravenoso o intraarticular en el control del sangrado posquirúrgico tras una artroplastia total de cadera. Estudio prospectivo, controlado y aleatorizado. Rev Esp Cir Ortop Traumatol. 2019;63:138–145." ] ] "apendice" => array:1 [ 0 => array:1 [ "seccion" => array:3 [ 0 => array:4 [ "apendice" => "Patient's blood volume=(k1×height [m3])+(k2×weight [kg])+k3<ul class="elsevierStyleList" id="lis0005"><li class="elsevierStyleListItem" id="lsti0005">-Males: K1=.3699/K2=.3219/K3=.6041</li><li class="elsevierStyleListItem" id="lsti0010">-Females: K1=.3561/K2=.03308/K3=.1833</li></ul>" "etiqueta" => "Appendix A" "titulo" => "Annex 1<a class="elsevierStyleCrossRef" href="#bib0280">27</a>" "identificador" => "sec0090" ] 1 => array:4 [ "apendice" => "Total blood loss=patient's blood volume×(Hct(pre)−Hct(post)/mean Hct)" "etiqueta" => "Appendix B" "titulo" => "Annex 2<a class="elsevierStyleCrossRef" href="#bib0285">28</a>" "identificador" => "sec0095" ] 2 => array:4 [ "apendice" => "Hidden blood loss=total blood loss−drained volume at 72h." "etiqueta" => "Appendix C" "titulo" => "Annex 3<a class="elsevierStyleCrossRef" href="#bib0290">29</a>" "identificador" => "sec0100" ] ] ] ] "multimedia" => array:4 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 2019 "Ancho" => 2342 "Tamanyo" => 275413 ] ] "descripcion" => array:1 [ "en" => "Consolidated Standards of Reporting Trials (CONSORT). Diagram for the study." ] ] 1 => array:8 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at1" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:3 [ "leyenda" => "ASA: American Society of Anesthesiologists; SD: standard deviation, BMI: body mass index; n: number." "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Overall (n=78) \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Group TXA_IV (n=31) \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Group TXA_IA (n=47) \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">p value<a class="elsevierStyleCrossRefs" href="#tblfn0005">a,b</a> \t\t\t\t\t\t\n \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Age (mean+SD) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">63.14±12.22 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">62.74±11.95 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">63.40±12.51 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">.817 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Female sex, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">35 (44.9) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">13 (41.9) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">22 (46.8) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">.672 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">BMI \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">28.47±3.91 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">28.52±3.98 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">28.44±3.91 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">.925 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="5" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"></td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="5" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">ASA n (%)</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">11 (14.1) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3 (9.7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">8 (17.0) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">59 (75.6) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">24 (77.4) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">35 (74.5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">8 (10.3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4 (12.9) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4 (8.5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">.581 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab2078786.png" ] ] ] "notaPie" => array:2 [ 0 => array:3 [ "identificador" => "tblfn0005" "etiqueta" => "a" "nota" => "p-Value: Student's t-test for independent samples." ] 1 => array:3 [ "identificador" => "tblfn0010" "etiqueta" => "b" "nota" => "χ2 test." ] ] ] "descripcion" => array:1 [ "en" => "Description of the sample according to the TXA administration route." ] ] 2 => array:8 [ "identificador" => "tbl0010" "etiqueta" => "Table 2" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at2" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:3 [ "leyenda" => "SD: standard deviation; n: number." "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Overall (n=78) \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Iv_TXA group (n=31) \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Ia_TXA group (n=47) \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">p value <a class="elsevierStyleCrossRef" href="#tblfn0015">*</a> \t\t\t\t\t\t\n \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Preoperative Hb, g/dl (mean+SD) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">14.253±1.261 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">14.284±1.483 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">14.232±1.107 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">.861 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Preoperative Hto (mean+SD) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">43.11±3.82 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">42.95±4.32 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">43.21±3.47 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">.768 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Hb 24h postop. (g/dl) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">11.177±1.441 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">11.132±1.649 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">11.206±1.303 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">.826 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Hto 24h postop. \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">33.08±3.87 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">32.55±4.17 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">33.43±3.65 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">.331 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Hb (72h postop.) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">10.827±1.362 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">10.538±1.568 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">11.017±1.187 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">.13 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Hto 72h postop. \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">32.04±3.71 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">31.10±4.15 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">32.66±3.29 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">.069 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Lowest Hb (g/dl) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">10.663±1.285 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">10.370±1.359 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">10.855±1.201 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">.104 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Patient's blood volume (ml) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4641.5 (3.380–6.045) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4537.0 (3.380–5.954) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4757 (3.403–6.045) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">.698<a class="elsevierStyleCrossRef" href="#tblfn0015">*</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Total blood loss (ml) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.369.59±428.79 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.505.42±499.32 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.280.00±352.89 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">.022 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Hidden blood loss (ml) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.084.53±444.34 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.285.74± 492.88 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">951.81±356.07 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">.001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Drainage 24h (ml) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">230.83±147.44 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">195.80±176.49 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">253.93±121.26 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">.088 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Median (minimum–maximum) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">245.00 (0–850) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">200.00 (0–850) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">250.00 (0–500) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Drainage 48h (ml) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">288.12±170.69 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">225.33±184.62 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">328.19±149.78 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">.009 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Median (minimum-maximum) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">300.00 (0–900) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">200.00 (0–900) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">300.00 (0–650) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Days of hospital stay \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5.05±1.06 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5.13±.91 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5.0±1.16 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">.595 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="5" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"></td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="5" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Transfusion, n (%)</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">74 (94.9) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">28 (90.3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">46 (97.9) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Yes \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4 (5.1) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3 (9.7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 (2.1) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">.139 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab2078787.png" ] ] ] "notaPie" => array:1 [ 0 => array:3 [ "identificador" => "tblfn0015" "etiqueta" => "*" "nota" => "Mann–Whitney U test. Descriptive analysis mean±standard deviation and p value Student's t-test for independent samples." ] ] ] "descripcion" => array:1 [ "en" => "Drainage levels and haemoglobin (HB) levels and haematocrit (Htc) pre and post surgery. Median (minimum and maximum)." ] ] 3 => array:8 [ "identificador" => "tbl0015" "etiqueta" => "Table 3" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at3" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:3 [ "leyenda" => "SD: standard deviation; n: number; ADR: adverse drug reaction." "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Overall (n=78) \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Iv_TXA group (n=31) \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Ia_TXA group (n=47) \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">p value<a class="elsevierStyleCrossRefs" href="#tblfn0020">a,b</a> \t\t\t\t\t\t\n \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="5" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Anaesthesia</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">General, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">33 (42.3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">10 (32.3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">23 (48.9) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Spinal, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">44 (56.4) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">20 (64.5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">24 (51.1) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Spinal+general, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 (1.3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 (3.2) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">.188 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="5" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"></td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="5" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Laterality</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Right, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">43 (55.1) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">19 (61.3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">24 (51.1) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Left, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">35 (44.9) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">12 (38.7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">23 (48.9) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">.374 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="5" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"></td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="5" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Approach</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Anterolateral, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">17 (21.8) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3 (9.7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">14 (29.8) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Posterolateral, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">61 (78.2) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">28 (90.3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">33 (70.2) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">.031 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="5" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"></td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="5" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Complications</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">No complications, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">74 (94.9) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">30 (96.8) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">44 (93.6) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Fissure, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 (1.3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 (2.1) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Calcar fracture, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 (1.3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 (2.1) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">ADR bemiparin \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 (1.3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 (3.2) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Seroma, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 (1.3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 (2.1) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">.476 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Surgery time (min) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">105.91±21.60 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">109.35±25.01 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">103.6±18.93 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">.255 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab2078785.png" ] ] ] "notaPie" => array:2 [ 0 => array:3 [ "identificador" => "tblfn0020" "etiqueta" => "a" "nota" => "p value: Student's t-test for independent samples." ] 1 => array:3 [ "identificador" => "tblfn0025" "etiqueta" => "b" "nota" => "χ2 test." ] ] ] "descripcion" => array:1 [ "en" => "Description of the sample in relation to the characteristics of the intervention and according to the administration of tranexamic acid (TXA)." ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:29 [ 0 => array:3 [ "identificador" => "bib0150" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Topical versus systemic tranexamic acid after total knee and hip arthroplasty: a meta-analysis of randomized controlled trials" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "Y. Chen" 1 => "Z. Chen" 2 => "S. Cui" 3 => "Z. Li" 4 => "Z. Yuan" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:4 [ "tituloSerie" => "Medicine (Baltimore)" "fecha" => "2016" "volumen" => "95" "paginaInicial" => "e4656" ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0155" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Blood management strategies for total knee arthroplasty [abstract]" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "B.R. Levine" 1 => "B. Haughom" 2 => "B. Strong" 3 => "M. Hellman" 4 => "R.M. Frank" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.5435/JAAOS-22-06-361" "Revista" => array:6 [ "tituloSerie" => "J Am Acad Orthop Surg" "fecha" => "2014" "volumen" => "22" "paginaInicial" => "361" "paginaFinal" => "371" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24860132" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0160" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Blood transfusion in primary total hip and knee arthroplasty. Incidence, risk factors, and thirty-day complication rates" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "A. Hart" 1 => "J.A. Khalil" 2 => "A. Carli" 3 => "O. Huk" 4 => "D. Zukor" 5 => "J. Antoniou" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.2106/JBJS.N.00077" "Revista" => array:6 [ "tituloSerie" => "J Bone Joint Surg Am" "fecha" => "2014" "volumen" => "96" "paginaInicial" => "1945" "paginaFinal" => "1951" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25471908" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0165" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Comparing efficacy of three methods of tranexamic acid administration in reducing hemoglobin drop following total knee arthroplasty" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "M.M. Sarzaeem" 1 => "M. Razi" 2 => "G. Kazemian" 3 => "M.E. Moghaddam" 4 => "A.M. Rasi" 5 => "M. Karimi" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.arth.2014.02.031" "Revista" => array:6 [ "tituloSerie" => "J Arthroplasty" "fecha" => "2014" "volumen" => "29" "paginaInicial" => "1521" "paginaFinal" => "1524" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24726174" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0170" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Anemia and patient blood management in hip and knee surgery: a systematic review of the literature" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "D.R. Spahn" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1097/ALN.0b013e3181e08e97" "Revista" => array:6 [ "tituloSerie" => "Anesthesiology" "fecha" => "2010" "volumen" => "113" "paginaInicial" => "482" "paginaFinal" => "495" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20613475" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0175" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Patient blood management in orthopaedic surgery" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "F. Canillas" 1 => "S. Gomez-Ramirez" 2 => "J.A. Garcia-Erce" 3 => "J. Pavia-Molina" 4 => "A. Gomez-Luque" 5 => "M. Munoz" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.recot.2014.11.005" "Revista" => array:6 [ "tituloSerie" => "Rev Esp Cir Ortop Traumatol" "fecha" => "2015" "volumen" => "59" "paginaInicial" => "137" "paginaFinal" => "149" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25650076" "web" => "Medline" ] ] ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0180" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Antifibrinolytic agents in current anaesthetic practice: use of tranexamic acid in lower limb arthroplasty" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "M. Muñoz" 1 => "J.A. Páramo" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1093/bja/aeu078" "Revista" => array:6 [ "tituloSerie" => "Br J Anaesth" "fecha" => "2014" "volumen" => "112" "paginaInicial" => "766" "paginaFinal" => "767" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24645160" "web" => "Medline" ] ] ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0185" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Intravenous tranexamic acid as an adjunct haemostat to ornipressin during open myomectomy. A randomized double blind placebo controlled trial" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "S. Ngichabe" 1 => "T. Obura" 2 => "W. Stones" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1186/s13022-015-0017-y" "Revista" => array:5 [ "tituloSerie" => "Ann Surg Innov Res" "fecha" => "2015" "volumen" => "9" "paginaInicial" => "10" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26568770" "web" => "Medline" ] ] ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib0190" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Low risk of thromboembolic complications with tranexamic acid after primary total hip and knee arthroplasty" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "B.P. Gillette" 1 => "L.J. DeSimone" 2 => "R.T. Trousdale" 3 => "M.W. Pagnano" 4 => "R.J. Sierra" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s11999-012-2488-z" "Revista" => array:6 [ "tituloSerie" => "Clin Orthop Relat Res" "fecha" => "2013" "volumen" => "471" "paginaInicial" => "150" "paginaFinal" => "154" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22814857" "web" => "Medline" ] ] ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib0195" "etiqueta" => "10" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Topical tranexamic acid reduces blood loss and transfusion rates associated with primary total hip arthroplasty" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "C.-H. Chang" 1 => "Y. Chang" 2 => "D.W. Chen" 3 => "S.W.N. Ueng" 4 => "M.S. Lee" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s11999-013-3446-0" "Revista" => array:6 [ "tituloSerie" => "Clin Orthop Relat Res" "fecha" => "2014" "volumen" => "472" "paginaInicial" => "1552" "paginaFinal" => "1557" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24385043" "web" => "Medline" ] ] ] ] ] ] ] ] 10 => array:3 [ "identificador" => "bib0200" "etiqueta" => "11" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "A comparison of combined intravenous and topical administration of tranexamic acid with intravenous tranexamic acid alone for blood loss reduction after total hip arthroplasty: a meta-analysis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "X. Liu" 1 => "J. Liu" 2 => "G. Sun" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.ijsu.2017.03.031" "Revista" => array:6 [ "tituloSerie" => "Int J Surg" "fecha" => "2017" "volumen" => "41" "paginaInicial" => "34" "paginaFinal" => "43" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28336258" "web" => "Medline" ] ] ] ] ] ] ] ] 11 => array:3 [ "identificador" => "bib0205" "etiqueta" => "12" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Topical application of tranexamic acid in primary total hip arthroplasty: a randomized double-blind controlled trial" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "C. Yue" 1 => "P. Kang" 2 => "P. Yang" 3 => "J. Xie" 4 => "F. Pei" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.arth.2014.03.032" "Revista" => array:6 [ "tituloSerie" => "J Arthroplasty" "fecha" => "2014" "volumen" => "29" "paginaInicial" => "2452" "paginaFinal" => "2456" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24793893" "web" => "Medline" ] ] ] ] ] ] ] ] 12 => array:3 [ "identificador" => "bib0210" "etiqueta" => "13" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Comparison between intravenous and intra-articular regimens of tranexamic acid in reducing blood loss during total knee arthroplasty" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "A. Soni" 1 => "R. Saini" 2 => "A. Gulati" 3 => "R. Paul" 4 => "S. Bhatty" 5 => "S.R. Rajoli" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.arth.2014.03.039" "Revista" => array:6 [ "tituloSerie" => "J Arthroplasty" "fecha" => "2014" "volumen" => "29" "paginaInicial" => "1525" "paginaFinal" => "1527" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24814890" "web" => "Medline" ] ] ] ] ] ] ] ] 13 => array:3 [ "identificador" => "bib0215" "etiqueta" => "14" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Comparison of intravenous versus topical tranexamic acid in total knee arthroplasty: a prospective randomized study" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "J.N. Patel" 1 => "J. Spanyer" 2 => "L.S. Smith" 3 => "J. Huang" 4 => "M.R. Yakkanti" 5 => "A.L. Malkani" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.arth.2014.03.011" "Revista" => array:6 [ "tituloSerie" => "J Arthroplasty" "fecha" => "2014" "volumen" => "29" "paginaInicial" => "1528" "paginaFinal" => "1531" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24768543" "web" => "Medline" ] ] ] ] ] ] ] ] 14 => array:3 [ "identificador" => "bib0220" "etiqueta" => "15" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Transfusion indication RBC (PBM-02): gap analysis of a Joint Commission Patient Blood Management Performance Measure at a community hospital" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "E.M. De Leon" 1 => "A. Szallasi" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.2450/2012.0088-12" "Revista" => array:7 [ "tituloSerie" => "Blood Transfus" "fecha" => "2014" "volumen" => "12" "numero" => "Suppl. 1" "paginaInicial" => "s187" "paginaFinal" => "s190" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23149139" "web" => "Medline" ] ] ] ] ] ] ] ] 15 => array:3 [ "identificador" => "bib0225" "etiqueta" => "16" "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "American Society of Anesthesiologists. American Society of Anesthesiologists: ASA physical status classification system. Available at: <a href="https://www.asahq.org/resources/clinical-information/asa-physical-status-classification-system">https://www.asahq.org/resources/clinical-information/asa-physical-status-classification-system</a>. Published October 15, 2014." ] ] ] 16 => array:3 [ "identificador" => "bib0230" "etiqueta" => "17" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Ácido tranexámico en cirugía ortopédica" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "X. Aguilera-Roig" 1 => "M. Jordán-Sales" 2 => "L. Natera-Cisneros" 3 => "J.C. Monllau-García" 4 => "M.J. Martínez-Zapata" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.recot.2013.08.005" "Revista" => array:6 [ "tituloSerie" => "Rev Esp Cir Ortop Traumatol" "fecha" => "2014" "volumen" => "58" "paginaInicial" => "52" "paginaFinal" => "56" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24126146" "web" => "Medline" ] ] ] ] ] ] ] ] 17 => array:3 [ "identificador" => "bib0235" "etiqueta" => "18" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Efecto de dosis única intravenosa de ácido tranexámico sobre el sangrado en artroplastia total de cadera. Estudio prospectivo, controlado y aleatorizado" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "A.B. Fernández-Cortiñas" 1 => "J.M. Quintáns-Vázquez" 2 => "F. Gómez-Suárez" 3 => "O.S. Murillo" 4 => "B.R. Sánchez-López" 5 => "J.M. Pena-Gracía" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.recot.2017.03.009" "Revista" => array:6 [ "tituloSerie" => "Rev Esp Cir Ortop Traumatol" "fecha" => "2017" "volumen" => "61" "paginaInicial" => "289" "paginaFinal" => "295" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28689785" "web" => "Medline" ] ] ] ] ] ] ] ] 18 => array:3 [ "identificador" => "bib0240" "etiqueta" => "19" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Eficacia de 2 gramos intravenosos de ácido tranexámico en la reducción del sangrado postoperatorio de la artroplastia total de cadera y rodilla" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "M. Castro-Menéndez" 1 => "S. Pena-Paz" 2 => "F. Rocha-García" 3 => "N. Rodríguez-Casas" 4 => "R. Huici-Izco" 5 => "A. Montero-Viéites" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.recot.2016.05.001" "Revista" => array:6 [ "tituloSerie" => "Rev Esp Cir Ortop Traumatol" "fecha" => "2016" "volumen" => "60" "paginaInicial" => "315" "paginaFinal" => "324" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27342383" "web" => "Medline" ] ] ] ] ] ] ] ] 19 => array:3 [ "identificador" => "bib0245" "etiqueta" => "20" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Topical application of tranexamic acid reduces postoperative blood loss in total knee arthroplasty: a randomized, controlled trial" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "J. Wong" 1 => "A. Abrishami" 2 => "H. El Beheiry" 3 => "N.N. Mahomed" 4 => "J. Roderick Davey" 5 => "R. Gandhi" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.2106/JBJS.I.01518" "Revista" => array:6 [ "tituloSerie" => "J Bone Joint Surg Am" "fecha" => "2010" "volumen" => "92" "paginaInicial" => "2503" "paginaFinal" => "2510" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21048170" "web" => "Medline" ] ] ] ] ] ] ] ] 20 => array:3 [ "identificador" => "bib0250" "etiqueta" => "21" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Topical application of antifibrinolytic drugs for on-pump cardiac surgery: a systematic review and meta-analysis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "A. Abrishami" 1 => "F. Chung" 2 => "J. Wong" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s12630-008-9038-x" "Revista" => array:6 [ "tituloSerie" => "Can J Anaesth" "fecha" => "2009" "volumen" => "56" "paginaInicial" => "202" "paginaFinal" => "212" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19247741" "web" => "Medline" ] ] ] ] ] ] ] ] 21 => array:3 [ "identificador" => "bib0255" "etiqueta" => "22" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Intravenous versus topical tranexamic acid in primary total hip replacement: a systemic review and meta-analysis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "X. Sun" 1 => "Q. Dong" 2 => "Y.-G. Zhang" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.ijsu.2016.05.064" "Revista" => array:6 [ "tituloSerie" => "Int J Surg" "fecha" => "2016" "volumen" => "32" "paginaInicial" => "10" "paginaFinal" => "18" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27262881" "web" => "Medline" ] ] ] ] ] ] ] ] 22 => array:3 [ "identificador" => "bib0260" "etiqueta" => "23" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Intravenous versus topical tranexamic acid in primary total hip replacement: a meta-analysis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "P. Zhang" 1 => "Y. Liang" 2 => "P. Chen" 3 => "Y. Fang" 4 => "J. He" 5 => "J. Wang" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:4 [ "tituloSerie" => "Medicine (Baltimore)" "fecha" => "2016" "volumen" => "95" "paginaInicial" => "e5573" ] ] ] ] ] ] 23 => array:3 [ "identificador" => "bib0265" "etiqueta" => "24" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Intra-articular injection of tranexamic acid reduce blood loss in cemented total knee arthroplasty" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "G. Digas" 1 => "I. Koutsogiannis" 2 => "G. Meletiadis" 3 => "E. Antonopoulou" 4 => "V. Karamoulas" 5 => "C. Bikos" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s00590-015-1664-8" "Revista" => array:6 [ "tituloSerie" => "Eur J Orthop Surg Traumatol" "fecha" => "2015" "volumen" => "25" "paginaInicial" => "1181" "paginaFinal" => "1188" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26169991" "web" => "Medline" ] ] ] ] ] ] ] ] 24 => array:3 [ "identificador" => "bib0270" "etiqueta" => "25" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Topical vs intravenous tranexamic acid in primary total hip arthroplasty: a double-blind randomized controlled trial" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "W.T. North" 1 => "N. Mehran" 2 => "J.J. Davis" 3 => "C.D. Silverton" 4 => "R.M. Weir" 5 => "M.W. Laker" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.arth.2015.11.003" "Revista" => array:6 [ "tituloSerie" => "J Arthroplasty" "fecha" => "2016" "volumen" => "31" "paginaInicial" => "1022" "paginaFinal" => "1026" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26703193" "web" => "Medline" ] ] ] ] ] ] ] ] 25 => array:3 [ "identificador" => "bib0275" "etiqueta" => "26" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The effect of tranexamic acid on transfusion rate in primary total hip arthroplasty" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "T.C. Wind" 1 => "W.R. Barfield" 2 => "J.T. Moskal" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.arth.2013.05.026" "Revista" => array:6 [ "tituloSerie" => "J Arthroplasty" "fecha" => "2014" "volumen" => "29" "paginaInicial" => "387" "paginaFinal" => "389" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23790499" "web" => "Medline" ] ] ] ] ] ] ] ] 26 => array:3 [ "identificador" => "bib0280" "etiqueta" => "27" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Prediction of blood volume in normal human adults" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "S.B. Nadler" 1 => "J.H. Hidalgo" 2 => "T. Bloch" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Surgery" "fecha" => "1962" "volumen" => "51" "paginaInicial" => "224" "paginaFinal" => "232" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21936146" "web" => "Medline" ] ] ] ] ] ] ] ] 27 => array:3 [ "identificador" => "bib0285" "etiqueta" => "28" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Estimating allowable blood loss: corrected for dilution" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "J.B. Gross" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1097/00000542-198303000-00016" "Revista" => array:6 [ "tituloSerie" => "Anesthesiology" "fecha" => "1983" "volumen" => "58" "paginaInicial" => "277" "paginaFinal" => "280" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/6829965" "web" => "Medline" ] ] ] ] ] ] ] ] 28 => array:3 [ "identificador" => "bib0290" "etiqueta" => "29" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Topical and intravenous tranexamic acid reduce blood loss compared to routine hemostasis in total knee arthroplasty: a multicenter, randomized, controlled trial" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "X. Aguilera" 1 => "M.J. Martínez-Zapata" 2 => "P. Hinarejos" 3 => "M. Jordán" 4 => "J. Leal" 5 => "J.C. 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Original Article

Which route of administration of acid tranexamic, intravenous or intra-articular, is more effective in the control of post-surgical bleeding after a total hip arthroplasty? A prospective, controlled and randomized study

Aplicación del tranexámico intravenoso o intraarticular en el control del sangrado posquirúrgico tras una artroplastia total de cadera. Estudio prospectivo, controlado y aleatorizado

P. Gómez Barberoa,

Corresponding author

gomez.barbero.patricia@gmail.com

Corresponding author.

, M.S. Gómez Aparicioa, J.A. Blas Dobóna, J.M. Pelayo de Tomása, M. Morales Suárez-Varelab, J.L. Rodrigo Péreza

a Servicio de Cirugía Ortopédica y Traumatología, Hospital Universitario Doctor Peset, Valencia, Spain

b Área de Medicina Preventiva y Salud Pública, Epidemiología, Universidad de Valencia, Valencia, Spain

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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Total hip arthroscopy is one of the most common interventions in the treatment of osteoarticular hip pain secondary to arthrosis or avascular necrosis of the femoral head&#46; One of the most frequent complications of surgery is large-scale intraoperative bleeding that will continue postoperatively&#46; Previous studies have shown ranges of blood loss from 1&#46;188<span class="elsevierStyleHsp" style=""></span>ml to 1&#46;651<span class="elsevierStyleHsp" style=""></span>ml&#46;<a class="elsevierStyleCrossRefs" href="#bib0150"><span class="elsevierStyleSup">1&#44;2</span></a> Furthermore&#44; it has been observed that between 10&#37; and 38&#37; of patients undergoing arthroplasty require an average 2<span class="elsevierStyleHsp" style=""></span>units of packed erythrocytes to minimise the haemoglobin and haematocrit drop&#46;<a class="elsevierStyleCrossRefs" href="#bib0160"><span class="elsevierStyleSup">3&#44;4</span></a> No allogenic blood transfusion is risk-free&#44; and in addition to adding to costs&#44; it significantly increases complications&#58; postoperative infections&#44; hospital stay&#44; mortality or delayed physical recovery&#44; for example&#46;<a class="elsevierStyleCrossRef" href="#bib0170"><span class="elsevierStyleSup">5</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">Many strategies have been deployed to reduce postoperative bleeding and the number of transfusions after prosthetic surgery&#44; including autologous donation&#44; intraoperative controlled hypotension&#44; regional anaesthesia&#44; blood saving measures&#44; erythropoietin and antifibrinolytic agents&#46; Tranexamic acid &#40;TXA&#41;&#44; marketed as Amchafibrin<span class="elsevierStyleSup">&#174;</span> is the most powerful and has the fewest complications of the antifibrinolytic agents&#46; Its administration inhibits the activation of plasminogen to plasmin&#44; through blocking the lysine binding site&#44; and prevents fibrin degradation&#46;<a class="elsevierStyleCrossRefs" href="#bib0175"><span class="elsevierStyleSup">6&#44;7</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">Previous orthopaedic and cardiovascular surgery studies have demonstrated that TXA reduces postoperative bleeding and the amount of allogenic transfusions compared to a control group using routine haemostasis&#46;<a class="elsevierStyleCrossRefs" href="#bib0180"><span class="elsevierStyleSup">7&#44;8</span></a> Moreover&#44; it did not increase the number of thromboembolic events&#44; or surgical infections&#46;<a class="elsevierStyleCrossRefs" href="#bib0165"><span class="elsevierStyleSup">4&#44;9</span></a> However&#44; most of these prospective&#44; randomized or meta-analysis studies have focussed on the effectiveness&#44; efficacy and safety of tranexamic acid without specifying the optimal administration route&#46;<a class="elsevierStyleCrossRefs" href="#bib0195"><span class="elsevierStyleSup">10&#8211;12</span></a> Recently the benefits of topical administration of TXA have been published&#44; delivering a maximum concentration to the surgical site with low systemic effect&#46;<a class="elsevierStyleCrossRef" href="#bib0195"><span class="elsevierStyleSup">10</span></a> Therefore&#44; we consider it necessary to undertake a study to clarify which administration route&#44; topical or intravenous&#44; is superior and equally safe in reducing postoperative bleeding after a primary hip arthroplasty&#46; To that end we evaluated two independent parameters&#44; the volume of blood drained and total blood loss&#44; taking into account the need for transfusions&#46; We presumed that the topical application &#40;intra-articular&#41; of TXA after closure would reduce postoperative bleeding and help maintain haemodynamic stability as well as its intravenous use&#46; Our secondary aim was to analyse whether either of the administration routes reduced the number of allogenic blood transfusions and the incidence of possible thromboembolic events more than the other&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Material and method</span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Design</span><p id="par0020" class="elsevierStylePara elsevierViewall">We undertook a prospective and randomized&#44; two-arm&#44; phase IV clinical trial in the Doctor Peset University Hospital of Valencia after approval from the clinical research ethics committee&#46; Group A &#40;arm A&#41; were given 15<span class="elsevierStyleHsp" style=""></span>mg&#47;kg of TXA intravenously 15&#8211;20<span class="elsevierStyleHsp" style=""></span>min before the end of the surgical intervention&#46; Group B &#40;arm B&#41; received 2 grams of intra-articular TXA in 100<span class="elsevierStyleHsp" style=""></span>ml of saline via the Redon drain&#44; once the wound had been closed&#59; the Redon drain was then clamped for 2<span class="elsevierStyleHsp" style=""></span>h&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">The dose of TXA we used was based on previous studies according to routine clinical practice&#46;<a class="elsevierStyleCrossRefs" href="#bib0210"><span class="elsevierStyleSup">13&#44;14</span></a></p><p id="par0030" class="elsevierStylePara elsevierViewall">We did not require a control group&#44; because there is already sufficient published literature demonstrating the usefulness and safety of TXA as an antifibrinolytic agent to reduce postoperative bleeding&#44; which is already marketed as Amchafibrin<span class="elsevierStyleSup">&#174;</span>&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Study population and sample size</span><p id="par0035" class="elsevierStylePara elsevierViewall">The study was performed on patients who underwent elective total hip arthroplasty due to coxarthrosis or avascular necrosis in the period between February 2017 and February 2018&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">Given that at the time of starting the study there were no publications describing differences in the use of intravenous or intra-articular TXA after a total hip prosthesis&#44; we used a time criterion to calculate the sample size&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">All the patients who met the inclusion criteria were consecutively randomized by intervention demand into 2 groups or arms&#44; group A&#44; who received intravenous treatment with TXA plus routine haemostasis&#44; and group B&#44; who received intra-articular treatment plus routine haemostatis&#46; During the study the orthopaedic surgeon and the anaesthetist were not blinded due to the different tranexamic acid administration routes&#46; However&#44; the entire subsequent follow-up was undertaken homogeneously and in a standardised way for the 2 groups&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Selection criteria</span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Inclusion criteria</span><p id="par0050" class="elsevierStylePara elsevierViewall">All patients aged between 18 and 85 who had undergone a total hip replacement due to primary coxarthrosis or avascular necrosis were included in the study&#46; The patients had to have signed their informed consent for the surgical intervention and to take part in the study&#44; and have a recent lab test result confirming normality of platelet count&#44; INR and prothrombin time&#46;</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Exclusion criteria</span><p id="par0055" class="elsevierStylePara elsevierViewall">All patients who were allergic to tranexamic acid&#44; those who refused to participate in the study&#44; those with a secondary arthropathy &#40;rheumatoid arthritis&#44; post-traumatic arthritis&#44; psoriatic arthritis&#41;&#44; cardiovascular disease &#40;acute myocardial infarction&#44; atrial fibrillation&#44; angina&#44; grade 3&#8211;4 heart failure&#44; prior heart surgery&#41;&#44; cerebrovascular disease &#40;stroke&#44; transient ischaemic attack and vascular surgery&#44; thromboembolic disease &#40;deep vein thrombosis &#91;DVT&#93;&#44; fibrinolysis disorders and coagulopathies &#40;if INR<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>1&#46;4&#44; platelets<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>150&#44;000<span class="elsevierStyleHsp" style=""></span>&#215;<span class="elsevierStyleHsp" style=""></span>10<span class="elsevierStyleSup">9</span>&#47;l&#44; prothrombin time<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>1&#46;4&#41;&#44; liver and&#47;or kidney failure&#44; treatment with anticoagulants 7 days prior to the surgical intervention&#44; blood product rejection&#44; intraoperative complications &#40;anaesthetic or surgical&#41;&#44; those participating in another clinical trial&#44; and with preoperative haemoglobin levels<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>12<span class="elsevierStyleHsp" style=""></span>g&#47;dl were excluded from the study&#46;</p></span></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Variables studied</span><p id="par0060" class="elsevierStylePara elsevierViewall">The patients&#8217; sociodemographic variables were collected &#40;age at the time of the intervention&#44; sex&#44; weight&#44; height and body mass index&#41;&#44; medical history&#44; preanaesthetic assessment and variables relative to the intervention &#40;such as the type of anaesthesia used&#44; approach&#44; surgical time&#44; days of hospital stay and laterality&#41;&#46; The main clinical variables collected were preoperative and postoperative haemoglobin and haematocrit &#40;at 24<span class="elsevierStyleHsp" style=""></span>h and 72<span class="elsevierStyleHsp" style=""></span>h&#41;&#44; the lowest haemoglobin recorded during the hospital stay&#44; the patient&#39;s blood volume &#40;<a class="elsevierStyleCrossRef" href="#sec0090">Annex 1</a>&#41;&#44; total blood loss &#40;<a class="elsevierStyleCrossRef" href="#sec0095">Annex 2</a>&#41;&#44; hidden blood loss &#40;<a class="elsevierStyleCrossRef" href="#sec0100">Annex 3</a>&#41;&#44; and the drainage volume at 24 and 48<span class="elsevierStyleHsp" style=""></span>h &#40;ml&#41;&#46; In addition&#44; the number of blood units transfused and the complications from the intervention &#40;the wound developing infection or necrosis&#44; DVT&#44; PTE or death&#41; were gathered as secondary variables&#46;</p></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">The centre&#39;s surgical protocol</span><p id="par0065" class="elsevierStylePara elsevierViewall">All the interventions were performed by a team of orthopaedic surgeons with experience in primary hip arthroplasty&#46; All the patients received cementless models&#46;</p><p id="par0070" class="elsevierStylePara elsevierViewall">In the anaesthetic induction intravenous antibiotic prophylaxis was administered according to the hospital&#39;s infections committee&#46; During the entire operation haemostatis was undertaken using electrocoagulation of the blood vessels&#46; After the intervention we placed a number 12 vacuum drain&#44; which was removed after 48<span class="elsevierStyleHsp" style=""></span>h&#46; The topical TXA &#40;group B&#41; was inserted via the Redon drain&#44; once the wound had been closed&#44; which was then clamped for 2<span class="elsevierStyleHsp" style=""></span>h&#46; The Redon drains of the patients receiving intravenous TXA &#40;group A&#41; were opened after placing the compression bandage&#46; Six hours after the surgical intervention the patients received venous thromboembolism prophylaxis with low molecular weight bemiparin&#44; which was maintained for 30 days&#46;</p><p id="par0075" class="elsevierStylePara elsevierViewall">All the patients who were admitted followed the same blood transfusion protocol based on the perioperative transfusion guidelines of the National Institutes of Health Consensus Conference&#46;<a class="elsevierStyleCrossRef" href="#bib0220"><span class="elsevierStyleSup">15</span></a> Red blood cell transfusion was indicated should the patient&#39;s haemoglobin levels fall below 8<span class="elsevierStyleHsp" style=""></span>g&#47;dl&#44; or below 10<span class="elsevierStyleHsp" style=""></span>g&#47;dl if they had associated cardiopulmonary disease and symptoms of anaemia&#44; defined as syncope&#44; fatigue&#44; palpitations or dizziness&#46;</p><p id="par0080" class="elsevierStylePara elsevierViewall">Any complications such as thromboembolic events were noted and collected throughout the patients&#8217; hospital stay&#46; On discharge&#44; all the patients were given outpatient appointments 3 weeks after the intervention&#44; when any possible complications were assessed&#46;</p></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Data collection</span><p id="par0085" class="elsevierStylePara elsevierViewall">The patient data collection was undertaken homogeneously and in a standardised way for the 2 groups&#46; The data were collectively postoperatively by a different team of surgeons&#46; The haemoglobin levels and haematocrit at 24 and 72<span class="elsevierStyleHsp" style=""></span>h following the surgery&#44; the daily drained blood volumes&#44; whether or not a blood transfusion had been given&#44; and a series of the abovementioned demographic variables were recorded&#46; In this assessment phase the analysis was blinded&#46; In addition&#44; confusion bias was avoided since these were objective results&#46;</p></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0115">Statistical analysis</span><p id="par0090" class="elsevierStylePara elsevierViewall">Firstly a descriptive analysis was undertaken where normally distributed continuous variables were described as mean<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>standard deviation &#40;SD&#41;&#44; and those that were not normally distributed&#44; or non-Gaussian&#44; were described as median &#40;maximum&#8211;minimum&#41;&#46; The qualitative variables were described in frequencies and percentages&#46; The Kolmogorov&#8211;Smirnov test was used to check the variables&#8217; normality distribution&#46; The <span class="elsevierStyleItalic">&#967;</span><span class="elsevierStyleSup">2</span> test was used to study the association between qualitative variables&#46; The Student&#39;s <span class="elsevierStyleItalic">t</span>-test&#44; Mann&#8211;Whitney <span class="elsevierStyleItalic">U</span> test or ANOVA were used to study the differences between means according to the application conditions&#46; Differences with <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;05 were considered statistically significant in all the tests&#46; The computer analysis was performed using SPSS 22&#46;0&#46;</p></span><span id="sec0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0120">Ethical aspects</span><p id="par0095" class="elsevierStylePara elsevierViewall">This paper was completed after the approval of the Doctor Peset University Hospital&#39;s ethics committee&#44; in compliance with the recommendations of the 1964 Declaration of Helsinki&#46; All the patients included in the study signed their informed consent&#46;</p></span></span><span id="sec0065" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0125">Results</span><p id="par0100" class="elsevierStylePara elsevierViewall">Between February 2017 and February 2018&#44; 90 patients scheduled for primary hip arthroscopy were included in the study&#46; Of this initial group&#44; 12 patients were excluded from the study&#44; 8 because they did not meet the inclusion criteria&#44; 3 because they did not want to participate&#44; and one case was excluded during the follow-up when an iatrogenic fracture was confirmed that required intraoperative transfusions&#46; The final analysis was undertaken on 78 patients&#44; of whom 31 were randomized to group A and received the intravenous treatment&#44; and 47 patients to group B who received intra-articular TXA &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41;&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0105" class="elsevierStylePara elsevierViewall">No significant differences were found in terms of age&#44; sex&#44; body mass index or American Society of Anesthesiologists&#8217; classification<a class="elsevierStyleCrossRef" href="#bib0225"><span class="elsevierStyleSup">16</span></a> &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#41;&#46; The comorbidity associated with the surgical intervention was gathered and assessed&#59; chronic diseases such as arterial hypertension&#44; diabetes mellitus and dyslipaemia under treatment were found in 66&#46;66&#37; of the patients &#40;52 cases&#41;&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0110" class="elsevierStylePara elsevierViewall">The preoperative haemoglobin levels and haematocrit were similar in both groups&#46; The fall in haemoglobin and mean haematocrit after the intervention was also similar&#46; In group A&#44; who received intravenous TXA&#44; we started with a mean preoperative Hb of 14&#46;28<span class="elsevierStyleHsp" style=""></span>g&#47;dl&#44; with a mean fall at 24<span class="elsevierStyleHsp" style=""></span>h of 3&#46;15<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;64<span class="elsevierStyleHsp" style=""></span>g&#47;dl&#44; and of 3&#46;75<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;56<span class="elsevierStyleHsp" style=""></span>g&#47;dl at 72<span class="elsevierStyleHsp" style=""></span>h&#46; The haematocrit suffered a mean drop of 10&#46;4<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>4&#46;17&#37; at 24<span class="elsevierStyleHsp" style=""></span>h&#44; and of 11&#46;85<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>4&#46;15&#37; at 72<span class="elsevierStyleHsp" style=""></span>h&#46; In group B&#44; with the intra-articular administration&#44; we started with a mean Hb of 14&#46;23<span class="elsevierStyleHsp" style=""></span>g&#47;dl&#44; and a mean fall of 3&#46;03<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;30<span class="elsevierStyleHsp" style=""></span>g&#47;dl was observed at 24<span class="elsevierStyleHsp" style=""></span>h&#44; and of 3&#46;22<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;2<span class="elsevierStyleHsp" style=""></span>g&#47;dl at 72<span class="elsevierStyleHsp" style=""></span>h&#46; The haematocrit dropped 10&#46;66<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>3&#46;6&#37; and 12&#46;11<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>3&#46;29&#37; at 24 and 72<span class="elsevierStyleHsp" style=""></span>h respectively&#46; The lowest recorded mean haemoglobin levels were 10&#46;3<span class="elsevierStyleHsp" style=""></span>g&#47;dl for group A&#44; and 10&#46;8<span class="elsevierStyleHsp" style=""></span>g&#47;dl for group B&#46; We found no significant differences between either group in any of the values studied &#40;<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0115" class="elsevierStylePara elsevierViewall">The mean drainage values in the first 24<span class="elsevierStyleHsp" style=""></span>h were 195&#46;80<span class="elsevierStyleHsp" style=""></span>ml in group A with intravenous administration compared to 253&#46;93<span class="elsevierStyleHsp" style=""></span>ml collected from group B&#44; with the intra-articular administration&#46; At 48<span class="elsevierStyleHsp" style=""></span>h&#44; prior to removing the drain&#44; a mean drainage of 225&#46;33<span class="elsevierStyleHsp" style=""></span>ml was recorded for group A compared to the 328&#46;19<span class="elsevierStyleHsp" style=""></span>ml of group B&#59; there was a statistically significant association &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#46;009&#41; in the values collected at 48<span class="elsevierStyleHsp" style=""></span>h&#46; If we analyse the patient&#39;s blood volume and calculate the total blood loss after the surgery we see that the intravenous group lost 1505&#46;42<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>499&#46;32<span class="elsevierStyleHsp" style=""></span>ml&#44; while the intra-articular group lost 1280&#46;00<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>352&#46;89<span class="elsevierStyleHsp" style=""></span>ml&#44; showing a statistically significant association &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#46;022&#41;&#46;</p><p id="par0120" class="elsevierStylePara elsevierViewall">The proportion of patients who required a transfusion was 9&#46;7&#37; in group A&#44; whereas in group B 2&#46;1&#37; of the cases received a transfusion&#46;</p><p id="par0125" class="elsevierStylePara elsevierViewall">The surgery time and mean hospital stay were similar in both groups&#44; with no statistically significant association &#40;<a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><p id="par0130" class="elsevierStylePara elsevierViewall">In terms of complications&#44; of a total 78 operated patients&#44; we only had 4 cases with complications &#40;2 calcar fractures&#44; one case of symptoms of allergic reaction to bemiparin and one surgical infection&#41;&#46; No thromboembolic complications or complications secondary to the TXA administration route were found in the immediate postoperative period or in the follow-up &#40;<a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>&#41;&#46;</p></span><span id="sec0070" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0130">Discussion</span><p id="par0135" class="elsevierStylePara elsevierViewall">Total hip arthroplasty involves significant intra- and postoperative blood loss&#46; The onset of postsurgical anaemia can increase mortality and morbidity&#44; increase length of hospital stay and delay rehabilitation&#46;<a class="elsevierStyleCrossRef" href="#bib0230"><span class="elsevierStyleSup">17</span></a> Different processes have been developed over many years in order to minimise blood loss&#44; and thus prevent allogenic blood transfusion&#44; an invasive technique associated with major complications&#46;<a class="elsevierStyleCrossRef" href="#bib0155"><span class="elsevierStyleSup">2</span></a> Many studies report the benefits of tranexamic acid in reducing postoperative bleeding&#46;<a class="elsevierStyleCrossRefs" href="#bib0185"><span class="elsevierStyleSup">8&#44;18&#44;19</span></a> There has been increasing interest in the topical administration of TXA in recent years due to its direct application to the surgical site with local action which minimises systemic side effects&#46;<a class="elsevierStyleCrossRefs" href="#bib0195"><span class="elsevierStyleSup">10&#44;20&#44;21</span></a> When tranexamic acid is given intravenously it distributes intracellularly and extracellularly until it reaches its maximum concentration after 5&#8211;15<span class="elsevierStyleHsp" style=""></span>min&#44; increasing its risk of causing thromboembolic complications&#46;<a class="elsevierStyleCrossRefs" href="#bib0195"><span class="elsevierStyleSup">10&#44;22&#44;23</span></a> In our randomized clinical trial we demonstrated that there are no statistically significant differences in the topical administration of 2<span class="elsevierStyleHsp" style=""></span>g of tranexamic acid compared to the standard treatment of 15<span class="elsevierStyleHsp" style=""></span>mg&#47;kg intravenously&#44; in terms of falls in haemoglobin and haematocrit&#44; blood loss and the need for transfusions&#46; In a recently published meta-analysis similar results to ours were obtained in terms of reduced bleeding and minimising transfusions&#46;<a class="elsevierStyleCrossRef" href="#bib0260"><span class="elsevierStyleSup">23</span></a> However&#44; unlike our results&#44; they observed less of a fall in haemoglobin in the intravenous group&#44; without being able to ensure the superiority of this route&#59; probably due to insufficient data&#46;</p><p id="par0140" class="elsevierStylePara elsevierViewall">Many studies have demonstrated that the intra-articular route is not inferior to the standard intravenous administration after a total knee arthroplasty&#44;<a class="elsevierStyleCrossRefs" href="#bib0165"><span class="elsevierStyleSup">4&#44;12&#8211;14</span></a> some authors even recommend intra-articular administration as more effective&#44; since it is a direct and simple route that can be used for patients for whom the systemic use of TXA is contraindicated&#44; since its absorption from the joint is not very clinically significant&#46;<a class="elsevierStyleCrossRef" href="#bib0265"><span class="elsevierStyleSup">24</span></a> We found few publications on the hip that refer to statistically significant differences in decreased bleeding according to the administration route&#44; and the few we did find defend the intravenous route&#46;<a class="elsevierStyleCrossRefs" href="#bib0270"><span class="elsevierStyleSup">25&#44;26</span></a> Our study found very similar results&#44; but always with less total blood loss and lower falls in haemoglobin in the intra-articular group&#44; and there was a statistically significant association in some values&#46; Likewise&#44; the patients in the intra-articular administration group received fewer transfusions compared to the intravenous group&#44; and although we did not obtain a statistically significant result and we cannot confirm the superiority of one route over the other&#44; this constant tendency towards better results using the intra-articular route has encouraged us to use it in our clinical practice&#46;</p><p id="par0145" class="elsevierStylePara elsevierViewall">The administration of tranexamic acid has proved a safe technique&#44; since we have had no increase in complications &#40;PTE&#44; DVT or deep infections&#41;&#46; Only one patient in group B developed a seroma that required surgical cleaning and intravenous antibiotic therapy for 7 days&#46; However&#44; most authors recommend the topical route for patients with a potential risk of thromboembolic events&#46;<a class="elsevierStyleCrossRef" href="#bib0260"><span class="elsevierStyleSup">23</span></a></p><p id="par0150" class="elsevierStylePara elsevierViewall">Most publications make no mention of surgery time&#44;<a class="elsevierStyleCrossRef" href="#bib0235"><span class="elsevierStyleSup">18</span></a> therefore they consider that it might influence blood loss&#46; In our study we assessed the surgery time of the intravenous group &#40;109&#46;35<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>25&#46;01<span class="elsevierStyleHsp" style=""></span>min&#41; compared to the topical group &#40;103&#46;6<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>18&#46;9<span class="elsevierStyleHsp" style=""></span>min&#41;&#44; and found no statistically significant differences&#46;</p><p id="par0155" class="elsevierStylePara elsevierViewall">This study has some limitations&#46; Firstly&#44; we used sequential randomisation excluding patients with major cardiovascular comorbidities&#44; i&#46;e&#46;&#44; potentially thromboembolic patients&#46; Furthermore&#44; the number of cases allocated to each group was not equal&#44; and was too small to be able to demonstrate a statistically significant association&#46; Different surgeons participated which might have led to unequal intraoperative bleeding&#46; We excluded patients who required intraoperative blood transfusions to prevent potential biases in monitoring a population with no intraoperative complications&#46; And finally&#44; in our hospital we do not perform routine screening for PTE or DVT&#44; and therefore only Doppler ultrasonography was indicated in the event of clinical suspicion&#46; Any complications might have been underestimated if there had been any asymptomatic thromboembolic events&#46; The strengths of this paper are that it was a prospective&#44; randomized study with team of doctors&#44; surgical nurses and operating theatre that follow a rigorous protocol of action and data collection&#46;</p><p id="par0160" class="elsevierStylePara elsevierViewall">The doses of tranexamic acid that should be prescribed are still a matter of controversy&#46; Studies on the dose regimens are very heterogeneous&#44; and probably require larger samples to obtain valid results&#46; Our study used 15<span class="elsevierStyleHsp" style=""></span>mg&#47;kg intravenously and 2<span class="elsevierStyleHsp" style=""></span>g via the intra-articular route&#59; our doses were based on similar regimens recommended in Ref&#46;<a class="elsevierStyleCrossRef" href="#bib0230"><span class="elsevierStyleSup">17</span></a></p></span><span id="sec0075" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0135">Conclusion</span><p id="par0165" class="elsevierStylePara elsevierViewall">The different administration routes for tranexamic acid that we studied for primary total hip arthroplasty &#40;topical intra-articular versus intravenous&#41; have a similar effect in reducing postoperative bleeding&#46; We found no increase in complications with either of the 2 established regimens&#46; However&#44; we prefer the intra-articular route for patients with a thromboembolic risk&#46; Further studies are required with a larger number of cases to establish the optimal dose of tranexamic acid&#46;</p></span><span id="sec0080" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0140">Level of evidence</span><p id="par0170" class="elsevierStylePara elsevierViewall">Level of evidence II&#46;</p></span><span id="sec0085" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0145">Conflict of interests</span><p id="par0175" class="elsevierStylePara elsevierViewall">The authors have no conflict of interest to declare&#46;</p></span></span>"
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    "fechaRecibido" => "2018-03-12"
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            0 => "Tranexamic acid"
            1 => "Intravenous administration"
            2 => "Intra-articular administration"
            3 => "Total hip arthroplasty"
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            0 => "&#193;cido tranex&#225;mico"
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            2 => "V&#237;a intraarticular"
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        "titulo" => "Abstract"
        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Introduction</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">One of the most frequent complications after a total hip arthroplasty &#40;THA&#41; is bleeding&#44; intravenous tranexamic acid &#40;TXA&#41; is used to reduce it&#46; We considered it necessary to carry out a study to clarify which administration route is superior&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Material and method</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Prospective&#44; controlled and randomized study in 2 arms carried out between February 2017 and February 2018&#46; 15<span class="elsevierStyleHsp" style=""></span>mg&#47;kg of intravenous TXA were administered in group A and 2<span class="elsevierStyleHsp" style=""></span>g of intra-articular TXA in group B&#46; The values of haemoglobin and haematocrit were evaluated at 24<span class="elsevierStyleHsp" style=""></span>h-72<span class="elsevierStyleHsp" style=""></span>h&#44; blood loss volume&#44; drained blood volume&#44; transfusions and complications&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Results</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">78 patients were included&#44; 31 with intravenous treatment and 47 with intra-articular&#46; The decrease of haemoglobin in the intravenous group was 3&#46;15<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;64<span class="elsevierStyleHsp" style=""></span>g&#47;dl in 24<span class="elsevierStyleHsp" style=""></span>h and 3&#46;75<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;56<span class="elsevierStyleHsp" style=""></span>g&#47;dl in 72<span class="elsevierStyleHsp" style=""></span>h&#44; the haematocrit decreased by 10&#46;4<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>4&#46;17&#37; in 24<span class="elsevierStyleHsp" style=""></span>h and 11&#46;85<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>4&#46;15&#37; in 72<span class="elsevierStyleHsp" style=""></span>h&#46; In the intra-articular group there was a haemoglobin fall of 3&#46;03<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;30<span class="elsevierStyleHsp" style=""></span>g&#47;dl in 24<span class="elsevierStyleHsp" style=""></span>h and 3&#46;22<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;2<span class="elsevierStyleHsp" style=""></span>g&#47;dl in 72<span class="elsevierStyleHsp" style=""></span>h and the haematocrit fell by 10&#46;66<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>3&#46;6&#37; and 12&#46;11<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>3&#46;29&#37; in 24 and 72<span class="elsevierStyleHsp" style=""></span>h &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>&#46;05&#41;&#46; The mean drainage in 24<span class="elsevierStyleHsp" style=""></span>h was 195&#46;80<span class="elsevierStyleHsp" style=""></span>ml in group A versus 253&#46;93<span class="elsevierStyleHsp" style=""></span>ml in group B &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>&#46;05&#41; and in 48<span class="elsevierStyleHsp" style=""></span>h it was 225&#46;33<span class="elsevierStyleHsp" style=""></span>ml in group A and 328&#46;19<span class="elsevierStyleHsp" style=""></span>ml in group B &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#46;009&#41;&#46; The intravenous group lost an average of 1505<span class="elsevierStyleHsp" style=""></span>ml of blood compared to the 11&#44;280<span class="elsevierStyleHsp" style=""></span>ml of the intra-articular group&#46; In 5&#46;1&#37; of the cases&#44; transfusions were necessary&#46; We had no secondary complications&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusions</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">The different routes of administration of TXA in THA have a similar effect in the reduction of postoperative bleeding&#46; There was no evidence of an increase in complications&#46;</p></span>"
        "secciones" => array:4 [
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        "titulo" => "Resumen"
        "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Introducci&#243;n</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Una complicaci&#243;n frecuente tras una artroplastia total de cadera es el sangrado&#44; y para reducirlo se utiliza el &#225;cido tranex&#225;mico &#40;TXA&#41; intravenoso&#46; Recientemente se han publicado los beneficios de su aplicaci&#243;n t&#243;pica&#46; Consideramos necesario realizar un estudio que justifique qu&#233; v&#237;a de administraci&#243;n resulta superior&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Material y m&#233;todo</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Estudio prospectivo&#44; controlado&#44; aleatorizado en 2 brazos realizado entre febrero de 2017 a febrero de 2018&#46; En el grupo A se administr&#243; 15<span class="elsevierStyleHsp" style=""></span>mg&#47;kg TXA intravenoso y en el B 2<span class="elsevierStyleHsp" style=""></span>g TXA intraarticular&#46; Se evalu&#243; los valores de hemoglobina y hematocrito a las 24-72<span class="elsevierStyleHsp" style=""></span>horas&#44; volumen de sangre drenado&#44; volumen de sangre perdida&#44; transfusiones y complicaciones&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Resultados</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Fueron incluidos 78 pacientes&#44; 31 con tratamiento intravenoso y 47 intraarticular&#46; La hemoglobina descendi&#243; 3&#44;15<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#44;64<span class="elsevierStyleHsp" style=""></span>g&#47;dl en 24<span class="elsevierStyleHsp" style=""></span>horas y 3&#44;75<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#44;56<span class="elsevierStyleHsp" style=""></span>g&#47;dl en 72<span class="elsevierStyleHsp" style=""></span>horas en el grupo intravenoso&#44; el hematocrito descendi&#243; un 10&#44;4&#37;<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>4&#44;17&#37; en 24<span class="elsevierStyleHsp" style=""></span>horas y 11&#44;85&#37;<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>4&#44;15&#37; en 72<span class="elsevierStyleHsp" style=""></span>horas&#46; En el intraarticular se observ&#243; una ca&#237;da de hemoglobina de 3&#44;03<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#44;30<span class="elsevierStyleHsp" style=""></span>g&#47;dl en 24<span class="elsevierStyleHsp" style=""></span>horas y de 3&#44;22<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#44;2<span class="elsevierStyleHsp" style=""></span>g&#47;dl en 72<span class="elsevierStyleHsp" style=""></span>horas y el hematocrito descendi&#243; 10&#44;66&#37;<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>3&#44;6&#37; y 12&#44;11&#37;<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>3&#44;29&#37; en 24 y 72<span class="elsevierStyleHsp" style=""></span>horas &#40;p<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>0&#44;05&#41;&#46; El drenaje medio en 24<span class="elsevierStyleHsp" style=""></span>horas fue 195&#44;80<span class="elsevierStyleHsp" style=""></span>ml en el grupo A frente a 253&#44;93<span class="elsevierStyleHsp" style=""></span>ml en el grupo B &#40;p<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>0&#44;05&#41; y a las 48<span class="elsevierStyleHsp" style=""></span>horas 225&#44;33<span class="elsevierStyleHsp" style=""></span>ml en el grupo A y de 328&#44;19<span class="elsevierStyleHsp" style=""></span>ml en el grupo-B &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;009&#41;&#46; En el grupo intravenoso perdieron una media de 1&#46;505<span class="elsevierStyleHsp" style=""></span>ml de sangre frente a 1&#46;280<span class="elsevierStyleHsp" style=""></span>ml del grupo intraarticular&#46; Fueron necesarias un 5&#44;1&#37; de transfusiones&#46; No tuvimos complicaciones secundarias&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclusiones</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Las diferentes v&#237;as de administraci&#243;n del TXA en la artroplastia total de cadera tienen un efecto similar en la reducci&#243;n del sangrado postoperatorio sin evidenciar un incremento de complicaciones&#46;</p></span>"
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            "titulo" => "Material y m&#233;todo"
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          2 => array:2 [
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            "titulo" => "Resultados"
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      0 => array:2 [
        "etiqueta" => "&#9734;"
        "nota" => "<p class="elsevierStyleNotepara" id="npar0030">Please cite this article as&#58; G&#243;mez Barbero P&#44; G&#243;mez Aparicio MS&#44; Blas Dob&#243;n JA&#44; Pelayo de Tom&#225;s JM&#44; Morales Su&#225;rez-Varela M&#44; Rodrigo P&#233;rez JL&#46; Aplicaci&#243;n del tranex&#225;mico intravenoso o intraarticular en el control del sangrado posquir&#250;rgico tras una artroplastia total de cadera&#46; Estudio prospectivo&#44; controlado y aleatorizado&#46; Rev Esp Cir Ortop Traumatol&#46; 2019&#59;63&#58;138&#8211;145&#46;</p>"
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            "apendice" => "<p id="par0180" class="elsevierStylePara elsevierViewall">Patient&#39;s blood volume<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#40;<span class="elsevierStyleItalic">k</span>1<span class="elsevierStyleHsp" style=""></span>&#215;<span class="elsevierStyleHsp" style=""></span>height &#91;m<span class="elsevierStyleSup">3</span>&#93;&#41;<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>&#40;<span class="elsevierStyleItalic">k</span>2<span class="elsevierStyleHsp" style=""></span>&#215;<span class="elsevierStyleHsp" style=""></span>weight &#91;kg&#93;&#41;<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">k</span>3<ul class="elsevierStyleList" id="lis0005"><li class="elsevierStyleListItem" id="lsti0005"><span class="elsevierStyleLabel">-</span><p id="par0185" class="elsevierStylePara elsevierViewall">Males&#58; <span class="elsevierStyleItalic">K</span>1<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#46;3699&#47;<span class="elsevierStyleItalic">K</span>2<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#46;3219&#47;<span class="elsevierStyleItalic">K</span>3<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#46;6041</p></li><li class="elsevierStyleListItem" id="lsti0010"><span class="elsevierStyleLabel">-</span><p id="par0190" class="elsevierStylePara elsevierViewall">Females&#58; <span class="elsevierStyleItalic">K</span>1<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#46;3561&#47;<span class="elsevierStyleItalic">K</span>2<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#46;03308&#47;<span class="elsevierStyleItalic">K</span>3<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#46;1833</p></li></ul></p>"
            "etiqueta" => "Appendix A"
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            "apendice" => "<p id="par0195" class="elsevierStylePara elsevierViewall">Total blood loss<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>patient&#39;s blood volume<span class="elsevierStyleHsp" style=""></span>&#215;<span class="elsevierStyleHsp" style=""></span>&#40;Hct&#40;pre&#41;<span class="elsevierStyleHsp" style=""></span>&#8722;<span class="elsevierStyleHsp" style=""></span>Hct&#40;post&#41;&#47;mean Hct&#41;</p>"
            "etiqueta" => "Appendix B"
            "titulo" => "Annex 2<a class="elsevierStyleCrossRef" href="#bib0285"><span class="elsevierStyleSup">28</span></a>"
            "identificador" => "sec0095"
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            "apendice" => "<p id="par0200" class="elsevierStylePara elsevierViewall">Hidden blood loss<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>total blood loss<span class="elsevierStyleHsp" style=""></span>&#8722;<span class="elsevierStyleHsp" style=""></span>drained volume at 72<span class="elsevierStyleHsp" style=""></span>h&#46;</p>"
            "etiqueta" => "Appendix C"
            "titulo" => "Annex 3<a class="elsevierStyleCrossRef" href="#bib0290"><span class="elsevierStyleSup">29</span></a>"
            "identificador" => "sec0100"
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                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">11&#46;177<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;441&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">11&#46;132<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;649&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">11&#46;206<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;303&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;826&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Hto 24h postop&#46;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">33&#46;08<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>3&#46;87&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">32&#46;55<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>4&#46;17&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">33&#46;43<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>3&#46;65&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;331&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Hb &#40;72h postop&#46;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">10&#46;827<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;362&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">10&#46;538<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;568&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">11&#46;017<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;187&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;13&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Hto 72h postop&#46;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">32&#46;04<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>3&#46;71&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">31&#46;10<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>4&#46;15&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">32&#46;66<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>3&#46;29&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;069&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Lowest Hb &#40;g&#47;dl&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">10&#46;663<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;285&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">10&#46;370<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;359&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">10&#46;855<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;201&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;104&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Patient&#39;s blood volume &#40;ml&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4641&#46;5 &#40;3&#46;380&#8211;6&#46;045&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4537&#46;0 &#40;3&#46;380&#8211;5&#46;954&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4757 &#40;3&#46;403&#8211;6&#46;045&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;698<a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Total blood loss &#40;ml&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;369&#46;59<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>428&#46;79&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;505&#46;42<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>499&#46;32&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;280&#46;00<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>352&#46;89&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;022&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Hidden blood loss &#40;ml&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;084&#46;53<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>444&#46;34&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;285&#46;74<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span> 492&#46;88&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">951&#46;81<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>356&#46;07&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Drainage 24h &#40;ml&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">230&#46;83<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>147&#46;44&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">195&#46;80<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>176&#46;49&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">253&#46;93<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>121&#46;26&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;088&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Median &#40;minimum&#8211;maximum&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">245&#46;00 &#40;0&#8211;850&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">200&#46;00 &#40;0&#8211;850&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">250&#46;00 &#40;0&#8211;500&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Drainage 48h &#40;ml&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">288&#46;12<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>170&#46;69&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">225&#46;33<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>184&#46;62&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">328&#46;19<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>149&#46;78&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;009&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Median &#40;minimum-maximum&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">300&#46;00 &#40;0&#8211;900&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">200&#46;00 &#40;0&#8211;900&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">300&#46;00 &#40;0&#8211;650&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Days of hospital stay</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
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                          "etal" => false
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                        "paginaFinal" => "371"
                        "link" => array:1 [
                          0 => array:2 [
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                        "fecha" => "2014"
                        "volumen" => "96"
                        "paginaInicial" => "1945"
                        "paginaFinal" => "1951"
                        "link" => array:1 [
                          0 => array:2 [
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                            "web" => "Medline"
                          ]
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                        "paginaFinal" => "1524"
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                        "paginaInicial" => "137"
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                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "B&#46;P&#46; Gillette"
                            1 => "L&#46;J&#46; DeSimone"
                            2 => "R&#46;T&#46; Trousdale"
                            3 => "M&#46;W&#46; Pagnano"
                            4 => "R&#46;J&#46; Sierra"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1007/s11999-012-2488-z"
                      "Revista" => array:6 [
                        "tituloSerie" => "Clin Orthop Relat Res"
                        "fecha" => "2013"
                        "volumen" => "471"
                        "paginaInicial" => "150"
                        "paginaFinal" => "154"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22814857"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
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              "identificador" => "bib0195"
              "etiqueta" => "10"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Topical tranexamic acid reduces blood loss and transfusion rates associated with primary total hip arthroplasty"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "C&#46;-H&#46; Chang"
                            1 => "Y&#46; Chang"
                            2 => "D&#46;W&#46; Chen"
                            3 => "S&#46;W&#46;N&#46; Ueng"
                            4 => "M&#46;S&#46; Lee"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1007/s11999-013-3446-0"
                      "Revista" => array:6 [
                        "tituloSerie" => "Clin Orthop Relat Res"
                        "fecha" => "2014"
                        "volumen" => "472"
                        "paginaInicial" => "1552"
                        "paginaFinal" => "1557"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24385043"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            10 => array:3 [
              "identificador" => "bib0200"
              "etiqueta" => "11"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "A comparison of combined intravenous and topical administration of tranexamic acid with intravenous tranexamic acid alone for blood loss reduction after total hip arthroplasty&#58; a meta-analysis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "X&#46; Liu"
                            1 => "J&#46; Liu"
                            2 => "G&#46; Sun"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.ijsu.2017.03.031"
                      "Revista" => array:6 [
                        "tituloSerie" => "Int J Surg"
                        "fecha" => "2017"
                        "volumen" => "41"
                        "paginaInicial" => "34"
                        "paginaFinal" => "43"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28336258"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            11 => array:3 [
              "identificador" => "bib0205"
              "etiqueta" => "12"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Topical application of tranexamic acid in primary total hip arthroplasty&#58; a randomized double-blind controlled trial"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "C&#46; Yue"
                            1 => "P&#46; Kang"
                            2 => "P&#46; Yang"
                            3 => "J&#46; Xie"
                            4 => "F&#46; Pei"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.arth.2014.03.032"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Arthroplasty"
                        "fecha" => "2014"
                        "volumen" => "29"
                        "paginaInicial" => "2452"
                        "paginaFinal" => "2456"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24793893"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            12 => array:3 [
              "identificador" => "bib0210"
              "etiqueta" => "13"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Comparison between intravenous and intra-articular regimens of tranexamic acid in reducing blood loss during total knee arthroplasty"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "A&#46; Soni"
                            1 => "R&#46; Saini"
                            2 => "A&#46; Gulati"
                            3 => "R&#46; Paul"
                            4 => "S&#46; Bhatty"
                            5 => "S&#46;R&#46; Rajoli"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.arth.2014.03.039"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Arthroplasty"
                        "fecha" => "2014"
                        "volumen" => "29"
                        "paginaInicial" => "1525"
                        "paginaFinal" => "1527"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24814890"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            13 => array:3 [
              "identificador" => "bib0215"
              "etiqueta" => "14"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Comparison of intravenous versus topical tranexamic acid in total knee arthroplasty&#58; a prospective randomized study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "J&#46;N&#46; Patel"
                            1 => "J&#46; Spanyer"
                            2 => "L&#46;S&#46; Smith"
                            3 => "J&#46; Huang"
                            4 => "M&#46;R&#46; Yakkanti"
                            5 => "A&#46;L&#46; Malkani"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.arth.2014.03.011"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Arthroplasty"
                        "fecha" => "2014"
                        "volumen" => "29"
                        "paginaInicial" => "1528"
                        "paginaFinal" => "1531"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24768543"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            14 => array:3 [
              "identificador" => "bib0220"
              "etiqueta" => "15"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Transfusion indication RBC &#40;PBM-02&#41;&#58; gap analysis of a Joint Commission Patient Blood Management Performance Measure at a community hospital"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "E&#46;M&#46; De Leon"
                            1 => "A&#46; Szallasi"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.2450/2012.0088-12"
                      "Revista" => array:7 [
                        "tituloSerie" => "Blood Transfus"
                        "fecha" => "2014"
                        "volumen" => "12"
                        "numero" => "Suppl&#46; 1"
                        "paginaInicial" => "s187"
                        "paginaFinal" => "s190"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23149139"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            15 => array:3 [
              "identificador" => "bib0225"
              "etiqueta" => "16"
              "referencia" => array:1 [
                0 => array:1 [
                  "referenciaCompleta" => "American Society of Anesthesiologists&#46; American Society of Anesthesiologists&#58; ASA physical status classification system&#46; Available at&#58; <a href="https://www.asahq.org/resources/clinical-information/asa-physical-status-classification-system">https&#58;&#47;&#47;www&#46;asahq&#46;org&#47;resources&#47;clinical-information&#47;asa-physical-status-classification-system</a>&#46; Published October 15&#44; 2014&#46;"
                ]
              ]
            ]
            16 => array:3 [
              "identificador" => "bib0230"
              "etiqueta" => "17"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "&#193;cido tranex&#225;mico en cirug&#237;a ortop&#233;dica"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "X&#46; Aguilera-Roig"
                            1 => "M&#46; Jord&#225;n-Sales"
                            2 => "L&#46; Natera-Cisneros"
                            3 => "J&#46;C&#46; Monllau-Garc&#237;a"
                            4 => "M&#46;J&#46; Mart&#237;nez-Zapata"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.recot.2013.08.005"
                      "Revista" => array:6 [
                        "tituloSerie" => "Rev Esp Cir Ortop Traumatol"
                        "fecha" => "2014"
                        "volumen" => "58"
                        "paginaInicial" => "52"
                        "paginaFinal" => "56"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24126146"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            17 => array:3 [
              "identificador" => "bib0235"
              "etiqueta" => "18"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Efecto de dosis &#250;nica intravenosa de &#225;cido tranex&#225;mico sobre el sangrado en artroplastia total de cadera&#46; Estudio prospectivo&#44; controlado y aleatorizado"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "A&#46;B&#46; Fern&#225;ndez-Corti&#241;as"
                            1 => "J&#46;M&#46; Quint&#225;ns-V&#225;zquez"
                            2 => "F&#46; G&#243;mez-Su&#225;rez"
                            3 => "O&#46;S&#46; Murillo"
                            4 => "B&#46;R&#46; S&#225;nchez-L&#243;pez"
                            5 => "J&#46;M&#46; Pena-Grac&#237;a"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.recot.2017.03.009"
                      "Revista" => array:6 [
                        "tituloSerie" => "Rev Esp Cir Ortop Traumatol"
                        "fecha" => "2017"
                        "volumen" => "61"
                        "paginaInicial" => "289"
                        "paginaFinal" => "295"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28689785"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            18 => array:3 [
              "identificador" => "bib0240"
              "etiqueta" => "19"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Eficacia de 2 gramos intravenosos de &#225;cido tranex&#225;mico en la reducci&#243;n del sangrado postoperatorio de la artroplastia total de cadera y rodilla"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "M&#46; Castro-Men&#233;ndez"
                            1 => "S&#46; Pena-Paz"
                            2 => "F&#46; Rocha-Garc&#237;a"
                            3 => "N&#46; Rodr&#237;guez-Casas"
                            4 => "R&#46; Huici-Izco"
                            5 => "A&#46; Montero-Vi&#233;ites"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.recot.2016.05.001"
                      "Revista" => array:6 [
                        "tituloSerie" => "Rev Esp Cir Ortop Traumatol"
                        "fecha" => "2016"
                        "volumen" => "60"
                        "paginaInicial" => "315"
                        "paginaFinal" => "324"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27342383"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            19 => array:3 [
              "identificador" => "bib0245"
              "etiqueta" => "20"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Topical application of tranexamic acid reduces postoperative blood loss in total knee arthroplasty&#58; a randomized&#44; controlled trial"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "J&#46; Wong"
                            1 => "A&#46; Abrishami"
                            2 => "H&#46; El Beheiry"
                            3 => "N&#46;N&#46; Mahomed"
                            4 => "J&#46; Roderick Davey"
                            5 => "R&#46; Gandhi"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.2106/JBJS.I.01518"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Bone Joint Surg Am"
                        "fecha" => "2010"
                        "volumen" => "92"
                        "paginaInicial" => "2503"
                        "paginaFinal" => "2510"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21048170"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            20 => array:3 [
              "identificador" => "bib0250"
              "etiqueta" => "21"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Topical application of antifibrinolytic drugs for on-pump cardiac surgery&#58; a systematic review and meta-analysis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "A&#46; Abrishami"
                            1 => "F&#46; Chung"
                            2 => "J&#46; Wong"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1007/s12630-008-9038-x"
                      "Revista" => array:6 [
                        "tituloSerie" => "Can J Anaesth"
                        "fecha" => "2009"
                        "volumen" => "56"
                        "paginaInicial" => "202"
                        "paginaFinal" => "212"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19247741"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            21 => array:3 [
              "identificador" => "bib0255"
              "etiqueta" => "22"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Intravenous versus topical tranexamic acid in primary total hip replacement&#58; a systemic review and meta-analysis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "X&#46; Sun"
                            1 => "Q&#46; Dong"
                            2 => "Y&#46;-G&#46; Zhang"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.ijsu.2016.05.064"
                      "Revista" => array:6 [
                        "tituloSerie" => "Int J Surg"
                        "fecha" => "2016"
                        "volumen" => "32"
                        "paginaInicial" => "10"
                        "paginaFinal" => "18"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27262881"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            22 => array:3 [
              "identificador" => "bib0260"
              "etiqueta" => "23"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Intravenous versus topical tranexamic acid in primary total hip replacement&#58; a meta-analysis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "P&#46; Zhang"
                            1 => "Y&#46; Liang"
                            2 => "P&#46; Chen"
                            3 => "Y&#46; Fang"
                            4 => "J&#46; He"
                            5 => "J&#46; Wang"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:4 [
                        "tituloSerie" => "Medicine &#40;Baltimore&#41;"
                        "fecha" => "2016"
                        "volumen" => "95"
                        "paginaInicial" => "e5573"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            23 => array:3 [
              "identificador" => "bib0265"
              "etiqueta" => "24"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Intra-articular injection of tranexamic acid reduce blood loss in cemented total knee arthroplasty"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "G&#46; Digas"
                            1 => "I&#46; Koutsogiannis"
                            2 => "G&#46; Meletiadis"
                            3 => "E&#46; Antonopoulou"
                            4 => "V&#46; Karamoulas"
                            5 => "C&#46; Bikos"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1007/s00590-015-1664-8"
                      "Revista" => array:6 [
                        "tituloSerie" => "Eur J Orthop Surg Traumatol"
                        "fecha" => "2015"
                        "volumen" => "25"
                        "paginaInicial" => "1181"
                        "paginaFinal" => "1188"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26169991"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            24 => array:3 [
              "identificador" => "bib0270"
              "etiqueta" => "25"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Topical vs intravenous tranexamic acid in primary total hip arthroplasty&#58; a double-blind randomized controlled trial"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "W&#46;T&#46; North"
                            1 => "N&#46; Mehran"
                            2 => "J&#46;J&#46; Davis"
                            3 => "C&#46;D&#46; Silverton"
                            4 => "R&#46;M&#46; Weir"
                            5 => "M&#46;W&#46; Laker"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.arth.2015.11.003"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Arthroplasty"
                        "fecha" => "2016"
                        "volumen" => "31"
                        "paginaInicial" => "1022"
                        "paginaFinal" => "1026"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26703193"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            25 => array:3 [
              "identificador" => "bib0275"
              "etiqueta" => "26"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The effect of tranexamic acid on transfusion rate in primary total hip arthroplasty"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "T&#46;C&#46; Wind"
                            1 => "W&#46;R&#46; Barfield"
                            2 => "J&#46;T&#46; Moskal"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.arth.2013.05.026"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Arthroplasty"
                        "fecha" => "2014"
                        "volumen" => "29"
                        "paginaInicial" => "387"
                        "paginaFinal" => "389"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23790499"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
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Article information

ISSN: 19888856
Original language: English

DOI:10.1016/j.recote.2019.01.001

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Year/Month	Html	Pdf	Total

2024 November	6	0	6
2024 October	18	4	22
2024 September	32	5	37
2024 August	22	4	26
2024 July	26	6	32
2024 June	17	4	21
2024 May	26	7	33
2024 April	31	5	36
2024 March	39	2	41
2024 February	39	6	45
2024 January	38	10	48
2023 December	29	13	42
2023 November	25	6	31
2023 October	34	8	42
2023 September	13	5	18
2023 August	25	3	28
2023 July	24	3	27
2023 June	21	2	23
2023 May	42	9	51
2023 April	38	0	38
2023 March	34	2	36
2023 February	37	10	47
2023 January	23	1	24
2022 December	11	6	17
2022 November	24	5	29
2022 October	20	5	25
2022 September	17	9	26
2022 August	29	16	45
2022 July	12	8	20
2022 June	66	7	73
2022 May	58	6	64
2022 April	24	11	35
2022 March	33	5	38
2022 February	20	4	24
2022 January	25	6	31
2021 December	22	14	36
2021 November	33	6	39
2021 October	40	11	51
2021 September	19	11	30
2021 August	37	10	47
2021 July	15	8	23
2021 June	16	10	26
2021 May	21	4	25
2021 April	27	9	36
2021 March	29	9	38
2021 February	11	9	20
2021 January	14	7	21
2019 June	1	0	1

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