DNP Project Title

Tranexamic Acid Use

Date of Award

Spring 5-8-2020

Document Type

DNP Project

Project Team Faculty Member

Debra Jenkins

Project Team Faculty Member

Rebecca Collier

Keywords

Tranexamic acid, TXA, antifibrinolytic, infusion protocol, pediatrics

Abstract

Bleeding is a risk associated with every surgery. The pediatric population represents unique challenges during surgery due to differences in anatomy and physiology when compared to the adult population. Historically, blood transfusions were the treatment for excessive surgical blood loss. Transfusion of blood products have associated risks: infection, volume overload, and immunological reactions (Fraser, Porte, Kouides, & Lukes, 2008; Porte & Leebeek, 2002; Yuan, Zhao, & Xu, 2016). Interventions to decrease blood loss are essential to improve surgical outcomes. Tranexamic acid (TXA) use decreases the number of required blood transfusions thereby decreasing transfusion-related morbidity (Lei, Xie, Xu, Xie, Huang, & Pei, 2017; Li, Sun, Luo, & Zhang, 2016; Porte & Leebeek, 2002; Sui, Ye, & Yang, 2016; Yuan, Zhao, & Xu, 2017). Decreased hemorrhage leads to improved hemodynamic stability, fewer transfusion requirements, and overall improved surgical outcomes in both adult and pediatric surgical procedures. The purpose of the project was to improve pediatric outcomes undergoing non-cardiac surgery in a tertiary care center in central Illinois through the development of a TXA infusion protocol. The results of the project implied there was an understanding of the protocol and intent on implementation. Recommendations for follow up to determine if the protocol is still being implemented could include a survey to anesthesia staff regarding protocol use and chart review of major non-cardiac pediatric surgeries.

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