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Systematic review and meta-analysis
Tranexamic acid reduces blood transfusion in surgical patients while its effects on thromboembolic events and mortality are uncertain
  1. Raviraj Raveendran,
  2. Jean Wong
  1. Department of Anesthesia, University of Toronto, Toronto, Ontario, Canada
  1. Correspondence to: Dr Jean Wong
    Department of Anesthesia, University of Toronto, Toronto Western Hospital 399 Bathurst Street, 2MC-434, Toronto, ON Canada M5T 2S8; jean.wong{at}

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Surgical trauma leads to the activation of local fibrinolysis, and surgical bleeding can be significant in certain types of surgery leading to acute anaemia and the need for blood transfusion. Clinical trends have led to reductions in acceptable haemoglobin transfusion thresholds. However, growing evidence from clinical and experimental studies suggests that acute haemodilutional anaemia may reduce tissue oxygen delivery and increase perioperative morbidity and mortality.1 Therefore, there is renewed interest in antifibrinolytic agents that may reduce surgical bleeding. Surgical trauma also leads to activation of the coagulation cascade and increases the risk for thromboembolic events. Therefore, the risks of thromboembolic and other adverse effects and the benefits of antifibrinolytic agents …

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  • Competing interests None.