Abstract

Liver resection can cause hyperfibrinolysis and alterations in hemostasis, placing the patient at risk for severe blood loss and blood transfusion administration. Because there are adverse consequences to not only blood loss but also to blood transfusion receipt, efforts should be made to reduce these events. The antifibrinolytic agent tranexamic acid (TXA) has shown benefit in numerous surgical settings in reducing blood loss and transfusion requirements, however, evidence regarding its usage in liver resection patients is lacking. The case report presents a 40-year-old female undergoing right hepatic lobectomy for neoplasm of the gallbladder. Packed red blood cells (PRBCs) were available for the procedure, and a type and screen and crossmatch were completed prior to surgery. Advanced monitoring included central venous pressure via central line and blood pressure via arterial line. As the liver vasculature was dissected, systolic blood pressure decreased from 90 mmHg to 33mmHg due to massive blood loss. Blood pressure was supported via vasopressors and fluid therapy as 3 units of PRBCs and 2 units of fresh frozen plasma were also administered. The blood pressure stabilized after these interventions. The patient experienced a total of 1800 mL of blood loss during the procedure. The patient remained stable upon transition to the intensive care unit.

Do patients presenting for liver resection who receive perioperative TXA experience less blood loss and receive less transfusions than patients who do not receive TXA?

Author Details

Katherine Caddell, BSN and Lisa Herbinger, DNP, CRNA

Sigma Membership

Epsilon Omega, Epsilon Omega, Epsilon Omega

Lead Author Affiliation

Samford University, Birmingham, Alabama, USA

Type

DNP Capstone Project

Format Type

Text-based Document

Study Design/Type

Case Study/Series

Research Approach

Translational Research/Evidence-based Practice

Keywords:

Tranexamic Acid, Liver Resection, Hepatic Surgery

Advisor

Herbinger, Lisa

Degree

Doctoral-Other

Degree Grantor

Samford University

Degree Year

2023

Rights Holder

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All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.

Review Type

None: Degree-based Submission

Acquisition

Self-submission

Date of Issue

2023-02-06

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