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Tranexamic acid use during Anesthesia for total joint replacements in Calgary

Does the use of intravenous tranexamic acid (TXA) by Calgary  anesthesiologists during total knee and hip replacement procedures  affect blood transfusion rates in the 72 hours following surgery?

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Anesthesiology, Orthopedic Surgery

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Don’t transfuse more than one Red cell unit at a time when transfusion is required in stable, non-bleeding patients.


Choosing Wisely Canada Recommendation

Background & Aim

Intravenous (IV) tranexamic acid (TXA) is used in a number of  different types of surgeries to reduce blood loss and the need for  transfusions. Literature and a local practice protocol support the use  of TXA in total hip (THA) and knee arthroplasty (TKA). Calgary  anesthesiologists perceive that there is practice variation in the  administration of TXA in THA and TKA.



This project aims to provide the anesthesiologists with:

  • data on their use of IV TXA in THA and TKA

  • patient outcomes surrounding the rate of post-operative RBC transfusions

  • audit-and-feedback intervention


South Health Campus Hospital anesethesiologists received their  individual data reports with peer comparator. Site-level data showed  variation in the frequency and dose of TXA adminstered




Use of IV TXA from Jan 1, 2014 - Jun 30, 2015 at South Health Campus Hospital

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Tranexamic acid use during total knee replacement surgery at South Health Campus Jan 1, 2014-Jun 30, 2015 (n=844)

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Patient outcomes within 72-hours following surgery





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Knowledge Translation

At the facilitated feedback session, South Health Calgary Hospital  anesthesiologists identified barriers and actions and three key themes:

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The Physician Learning Program is supporting anesthesiologists by helping generate repeat reports to surgeons and anesthesiologists.


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