Tranexamic acid in elective pediatric orthopedic surgery: a comprehensive review.

Abstract

Tranexamic acid (TXA), approved initially for medical bleeding, has expanded its utility to various surgical contexts, including pediatric orthopedic and trauma surgery, though limited research has been conducted in this population. This study aimed to evaluate TXA's efficacy and safety in pediatric orthopedic and trauma surgeries, focusing on its impact on blood loss reduction and transfusion requirements. Through a comprehensive literature review following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, eight retrospective studies were analyzed, all involving pediatric patients with cerebral palsy undergoing orthopedic surgery. TXA dosing regimens varied across studies, with loading doses ranging from 10 to 50 mg/kg and maintenance doses from 1 to 10 mg/kg/h. Consistently, TXA administration was associated with a significant decrease in intraoperative blood loss and transfusion needs compared with nonadministered groups, with no reported thromboembolic events, indicating its safety in pediatric orthopedic and trauma surgeries.