Implementation of prophylactic and systematic tranexamic acid administration in the surgical safety checklist for adult patients: a protocol proposal

Rita Q. Pereira; Diana C. Leão; Teresa Mota; Susana N. Fernandes; Susana Vargas; Fernando Abelha; Jorge Almeida; José A. Paiva; José Dias; Eunice Trindade; Tiago Pimenta; Ana Azevedo; Pedro Soares; Fernando Friões; Elisabete Barbosa; Fernando Araújo

doi:10.18203/2349-2902.isj20254331

Authors

Rita Q. Pereira Department of Immunohemotherapy, ULS São João, Porto, Portugal
Diana C. Leão Department of Immunohemotherapy, ULS São João, Porto, Portugal
Teresa Mota Department of Immunohemotherapy, ULS São João, Porto, Portugal
Susana N. Fernandes Department of Immunohemotherapy, ULS São João, Porto, Portugal
Susana Vargas Department of Central Operating Room, ULS São João, Porto, Portugal; Faculty of Medicine, University of Porto, Porto, Portugal
Fernando Abelha Faculty of Medicine, University of Porto, Porto, Portugal; Department of Anesthesiology, ULS São João, Porto, Portugal
Jorge Almeida Faculty of Medicine, University of Porto, Porto, Portugal; Department of Internal Medicine, ULS São João, Porto, Portugal
José A. Paiva Faculty of Medicine, University of Porto, Porto, Portugal; Department of Intensive Care Medicine, ULS São João, Porto, Portugal
José Dias Department of Central Operating Room, ULS São João, Porto, Portugal; Faculty of Medicine, University of Porto, Porto, Portugal
Eunice Trindade Faculty of Medicine, University of Porto, Porto, Portugal; Department of Pediatrics, ULS São João, Porto, Portugal
Tiago Pimenta Faculty of Medicine, University of Porto, Porto, Portugal; Department of General Surgery, ULS São João, Porto, Portugal
Ana Azevedo Faculty of Medicine, University of Porto, Porto, Portugal; Hospital Epidemiology Center, ULS São João, Porto, Portugal
Pedro Soares Department of Pharmacy, ULS São João, Porto, Portugal
Fernando Friões Faculty of Medicine, University of Porto, Porto, Portugal; Pharmacy and Therapeutics Committee, ULS São João, Porto, Portugal
Elisabete Barbosa Faculty of Medicine, University of Porto, Porto, Portugal; Department of General Surgery, ULS São João, Porto, Portugal
Fernando Araújo Department of Immunohemotherapy, ULS São João, Porto, Portugal; Faculty of Medicine, University of Porto, Porto, Portugal

DOI:

https://doi.org/10.18203/2349-2902.isj20254331

Keywords:

Tranexamic acid, Blood loss, Surgical, Surgical procedures, Operative, Perioperative care, Clinical protocols

Abstract

Background: The administration of tranexamic acid (TXA) in the surgical context has proven to be effective in reducing perioperative bleeding, both in cardiac and noncardiac surgery. Its low price and ease of use make it particularly advantageous. Despite existing evidence and international recommendations supporting its use in surgery, TXA remains underutilized and inconsistently used in surgery.

Methods: Furthermore, integrating this recommendation into the 'safe surgery' approach by establishing a consistent process may enhance its beneficial effect on patient clinical outcomes. Therefore, to increase and standardize the use of tranexamic acid in surgery, we considered including prophylactic administration of TXA in the 'surgical safety checklist' (SSC) at our hospital and implemented a protocol for its systematic prophylactic administration in adult surgical patients at risk of moderate to high blood loss.

Conclusions: A protocol based on current evidence, an innovative initiative implemented in a pioneering manner was presented at Unidade Local de Saúde São João.

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