High-Dose Tranexamic Acid Is Associated with Nonischemic Clinical Seizures in Cardiac Surgical Patients

@article{Murkin2010HighDoseTA,
  title={High-Dose Tranexamic Acid Is Associated with Nonischemic Clinical Seizures in Cardiac Surgical Patients},
  author={John M. Murkin and Florian Falter and Jeff T. Granton and Bryan Young and Christiana Burt and Michael W. A. Chu},
  journal={Anesthesia \& Analgesia},
  year={2010},
  volume={110},
  pages={350-353}
}
BACKGROUND: In 2 separate centers, we observed a notable increase in the incidence of postoperative convulsive seizures from 1.3% to 3.8% in patients having undergone major cardiac surgical procedures. These events were temporally coincident with the initial use of high-dose tranexamic acid (TXA) therapy after withdrawal of aprotinin from general clinical usage. The purpose of this review was to perform a retrospective analysis to examine whether there was a relation between TXA usage and… 
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The association between tranexamic acid and convulsive seizures after cardiac surgery: a multivariate analysis in 11 529 patients
TLDR
A retrospective analysis of prospectively collected data from 11 529 patients in whom cardiopulmonary bypass was used from January 2004 to December 2010 found tranexamic acid administration, particularly in doses exceeding 80 mgkg−1, should be weighed against the risk of postoperative seizures.
Tranexamic Acid in cardiac surgery and postoperative seizures: a case report series.
TLDR
Patients who had open-chamber cardiac surgery and developed seizures in the postoperative period are described, with an increased incidence compared with that of a cohort of patients in the previous 36 months who did not receive TxA.
Low-Dose Versus High-Dose Tranexamic Acid Reduces the Risk of Nonischemic Seizures After Cardiac Surgery With Cardiopulmonary Bypass.
TLDR
Lower doses of TXA were associated with a lower incidence of nonischemic seizures compared with higher doses of the drug.
Postoperative seizure in a neurosurgical patient: Should tranexamic acid be on the differential?
TLDR
A case of postoperative seizure of unclear etiology in a neurosurgical patient who received TXA intraoperatively and was transitioned to levetiracetam for the remainder of his hospitalization given the favourable safety and toxicity profile seen with this antiepileptic agent.
Moderate dosage of tranexamic acid during cardiac surgery with cardiopulmonary bypass and convulsive seizures: incidence and clinical outcome.
TLDR
In open-heart surgery, even moderate TA doses are associated with a doubled rate of CS and in-hospital mortality, and Prospective trials are needed to further evaluate the safety profile of TA in cardiac surgery.
Seizures following cardiac surgery: the impact of tranexamic acid and other risk factors
TLDR
The data suggest that multiple risk factors, including TA, are associated with seizures after cardiac surgery, and the TA dose may be a readily modifiable risk factor for postoperative seizures.
High-dose tranexamic acid is related to increased risk of generalized seizures after aortic valve replacement.
  • C. Keyl, R. Uhl, +4 authors D. Trenk
  • Medicine
    European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery
  • 2011
Risk factors associated with postoperative seizures in patients undergoing cardiac surgery who received tranexamic acid: a case-control study.
TLDR
An association between high preoperative creatinine value and postoperative seizure was identified and tranexamic acid may be associated with the development of postoperative seizures in patients with renal dysfunction.
Seizures after open heart surgery: comparison of ε-aminocaproic acid and tranexamic acid.
TLDR
Both lysine analogs are associated with significant side effects, which must be taken into account when performing risk-benefit analyses of their use, and their use should be restricted to patients at high risk for bleeding.
Safety and efficacy of aprotinin and tranexamic acid in pulmonary endarterectomy surgery with hypothermia: review of 200 patients.
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