TRANexamic Acid to Reduce Bleeding in BURN Surgery (TRANBURN)
The Effect of Tranexamic Acid (TXA) on Blood Loss in Burn Surgery - A Randomized, Double-Blinded Placebo-Controlled Trial
Excision and grafting in burn patients can lead to severe blood loss. A preliminary study conducted in Saint Joseph Saint Luc Hospital showed that the total median blood loss was 1412 mL (1). Transfused patients had a total median blood loss of 2468 mL and an average number of 4 packed red blood cells (PRBC) administered.
Among the various methods that help limit blood loss, tranexamic acid, which has been proved useful in traumatology and surgery, has not been sufficiently studied in burn patients. A preliminary study in 27 burned patients showed a reduction of blood loss with tranexamic acid (2).
Objective of TRANBURN study is to demonstrate that tranexamic acid help limit blood loss and reduces the use of blood products.
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
The first aim of the study is to demonstrate that tranexamic acid help limit blood loss and reduces the use of blood products.
Secondary objectives are to evaluate impact of tranexamic acid on mortality, success of skin grafts and occurrence of deep vein thrombosis or myocardial infarction.
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Phase 4
Contacts and Locations
Study Locations
-
-
-
Ars-Laquenexy, France
- Service de réanimation des brûlés de Mercy (CHR Metz-Thionville)
-
Lyon, France
- Centre Hospitalier Saint Joseph Saint Luc
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Lyon, France, 69437
- Centre Commun de Traitement des Brûlés - Hôpital Edouard Herriot
-
Marseille, France
- Centre des brûlés inter-régional Méditerranée - Hôpital de la Conception
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Subjects undergoing burn excision surgery for standard of care purposes
- Male or female >= 18 years of age
- Subject or subject's medical decision maker agrees to participate in this study and provides informed consent
Exclusion Criteria:
- Subjects with a history of hypercoagulopathy, deep vein thrombosis (DVT), pulmonary embolism
- Renal impairment
- Subjects with known hypersensitivity to tranexamic acid
- Consecutive fibrinolytic states to coagulopathy
- History of convulsions
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Quadruple
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: Tranexamic Acid
Patient will receive:
|
Other Names:
|
|
Placebo Comparator: Placebo
Patient will receive:
|
0.9% sodium chloride to mimic tranexamic acid
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Blood loss (mL / cm² excised)
Time Frame: Until day 5 post surgery
|
To determine the impact of tranexamic acid on blood loss in burn surgeries
|
Until day 5 post surgery
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Need for transfusion
Time Frame: Until day 5 post surgery
|
Number of blood product transfused
|
Until day 5 post surgery
|
|
All-cause Hospital Mortality
Time Frame: Until day 15 post surgery
|
Any death during hospital stay
|
Until day 15 post surgery
|
|
Success of skin graft
Time Frame: Until day 15 post surgery
|
Number of successful skin graft (medical assessment)
|
Until day 15 post surgery
|
|
Deep vein thrombosis
Time Frame: Until day 15 post surgery
|
Number of deep vein thrombosis
|
Until day 15 post surgery
|
|
Myocardial infarction
Time Frame: Until day 15 post surgery
|
Number of myocardial infarctions
|
Until day 15 post surgery
|
|
Stroke
Time Frame: Until day 15 post surgery
|
Number of strokes
|
Until day 15 post surgery
|
|
Pulmonary embolism
Time Frame: Until day 15 post surgery
|
Number of pulmonary embolisms
|
Until day 15 post surgery
|
|
Convulsion
Time Frame: Until day 15 post surgery
|
Number of convulsions
|
Until day 15 post surgery
|
Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Investigators
Investigators
- Principal Investigator: Mathieu Fontaine, MD, PhD, Saint Joseph Saint Luc Hospital, Burn Intensive Care Unit
Publications and helpful links
General Publications
- Ker K, Edwards P, Perel P, Shakur H, Roberts I. Effect of tranexamic acid on surgical bleeding: systematic review and cumulative meta-analysis. BMJ. 2012 May 17;344:e3054. doi: 10.1136/bmj.e3054.
- CRASH-2 trial collaborators; Shakur H, Roberts I, Bautista R, Caballero J, Coats T, Dewan Y, El-Sayed H, Gogichaishvili T, Gupta S, Herrera J, Hunt B, Iribhogbe P, Izurieta M, Khamis H, Komolafe E, Marrero MA, Mejia-Mantilla J, Miranda J, Morales C, Olaomi O, Olldashi F, Perel P, Peto R, Ramana PV, Ravi RR, Yutthakasemsunt S. Effects of tranexamic acid on death, vascular occlusive events, and blood transfusion in trauma patients with significant haemorrhage (CRASH-2): a randomised, placebo-controlled trial. Lancet. 2010 Jul 3;376(9734):23-32. doi: 10.1016/S0140-6736(10)60835-5. Epub 2010 Jun 14.
- Zufferey P, Merquiol F, Laporte S, Decousus H, Mismetti P, Auboyer C, Samama CM, Molliex S. Do antifibrinolytics reduce allogeneic blood transfusion in orthopedic surgery? Anesthesiology. 2006 Nov;105(5):1034-46. doi: 10.1097/00000542-200611000-00026.
- Desai MH, Herndon DN, Broemeling L, Barrow RE, Nichols RJ Jr, Rutan RL. Early burn wound excision significantly reduces blood loss. Ann Surg. 1990 Jun;211(6):753-9; discussion 759-62. doi: 10.1097/00000658-199006000-00015.
- Curinga G, Jain A, Feldman M, Prosciak M, Phillips B, Milner S. Red blood cell transfusion following burn. Burns. 2011 Aug;37(5):742-52. doi: 10.1016/j.burns.2011.01.016. Epub 2011 Mar 1.
- Farny B, Fontaine M, Payre J, Ravat F, Poupelin J-C, Latarjet J. Évaluation des pertes sanguines lors des chirurgies d'excision-autogreffe de peau chez les patients brûlés. Anesthésie & Réanimation. 2015;1:A307-8.
- Jennes S, Degrave E, Despiegeleer X, Grenez O. Effect of Tranexamic Acid on Blood Loss in Burn Surgery: A Preliminary Study. Journal of Burn Care & Rehabilitation. 2003;24:S59.
- Mercuriali F, Inghilleri G. Proposal of an algorithm to help the choice of the best transfusion strategy. Curr Med Res Opin. 1996;13(8):465-78. doi: 10.1185/03007999609115227.
Helpful Links
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- TRANBURN
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
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