Hemodynamics, fluids & transfusion
Topical Versus Intravenous Tranexamic Acid in Cardiac Surgery: A Meta-analysis of Randomized Controlled Trials
Pooled result · Total postoperative blood lossResult — go to the resultMD −16.66 95% CI −41.01 to 7.69Authors' conclusion
The findings suggest that topical and intravenous TXA demonstrate similar efficacy in reducing perioperative bleeding in cardiac surgery, with no significant differences in safety outcomes. However, topical TXA may have a delayed benefit in pediatric patients.
Study context
- Population
- Pediatric and/or adult patients undergoing cardiac surgery
- Participants
- 3,577 patients · 6 randomized controlled trials (RCTs)
- Comparison
- Topical vs intravenous tranexamic acid (TXA)
- Topical TXAn = 1,792
- Intravenous TXAn = 1,785reference
- Outcome
- Total postoperative blood loss
Methodological detailsPRISMA-compliant
- PRISMA-compliant
Pooled result
As reported in the abstract
MD
−16.66
95% CI −41.01 to 7.69
P = 0.18
Topical TXA vs Intravenous TXA
MD −16.66 (95% CI −41.01 to 7.69); P = 0.18
Further pooled results
| Outcome | MD (95% CI) | P value | |
|---|---|---|---|
| Blood loss at 48 hours, pediatric patients (subgroup) | −8.63 (−16.77 to −0.49) | P = 0.04 | |
| −20−10010Difference (linear scale) |
Blood loss at 24 hours, adults (subgroup)
- No significant difference
Hemoglobin level changes, transfusion requirements, clinical outcomes
- No significant differences
Mortality, reoperation, seizures, infections, respiratory failure, ICU LOS, ventilation duration
- Comparable rates
Original publication
Topical Versus Intravenous Tranexamic Acid in Cardiac Surgery: A Meta-analysis of Randomized Controlled Trials. J Cardiothorac Vasc Anesth. Published 20 January 2026. doi:10.
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