Hemodynamics, fluids & transfusion
The Effect of Prophylactic Use of Antifibrinolytics During Pediatric Non‐Cardiac Surgeries on Bleeding and Transfusions: A Systematic Review and Meta‐Analysis
Authors' conclusion
In craniofacial, scoliosis, and tonsillectomy/adenoidectomy surgery, prophylactic administration of tranexamic acid results in lower estimated blood loss. Tranexamic acid and aprotinin are effective for reducing transfusion in craniofacial surgery. For scoliosis surgery, tranexamic acid is more efficacious than aminocaproic acid.
Study context
- Population
- Patients under 18 years of age undergoing non-cardiac surgery130 articles
- Comparison
- Prophylactic intraoperative antifibrinolytics vs control
- Outcome
- Intraoperative blood loss and intraoperative blood transfusions
Pooled result
As reported in the abstract
Estimated blood loss and blood transfusion
- Tranexamic acid vs Control · scoliosis surgery
- estimated blood loss −410.0 mL; P = < 0.001
- Tranexamic acid vs Control · craniofacial surgery
- estimated blood loss −14.0 mL/kg; P = < 0.001
- Tranexamic acid vs Control · tonsillectomy/adenoidectomy surgery
- estimated blood loss −21.0 mL; P < 0.001
- Aminocaproic acid vs Control · scoliosis surgery
- estimated blood loss −464.0 mL; P < 0.001
- Tranexamic acid vs Aminocaproic acid · scoliosis surgery
- estimated blood loss −391.0 mL; P < 0.001
- Tranexamic acid vs Control · craniosynostosis surgery
- mean decrease in blood transfusion −7 mL/kg; P = 0.010
- Aprotinin vs Control · craniosynostosis surgery
- mean decrease in blood transfusion −20.0 mL/kg; P < 0.001
Original publication
The Effect of Prophylactic Use of Antifibrinolytics During Pediatric Non‐Cardiac Surgeries on Bleeding and Transfusions: A Systematic Review and Meta‐Analysis. Paediatr Anaesth. Published 6 June 2025. doi:10.
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