{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T15:28:48Z","timestamp":1787585328724,"version":"build-2736575974"},"reference-count":42,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2023,4,7]],"date-time":"2023-04-07T00:00:00Z","timestamp":1680825600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003399","name":"Science and Technology Commission of Shanghai Municipality","doi-asserted-by":"publisher","award":["20Y11906200"],"award-info":[{"award-number":["20Y11906200"]}],"id":[{"id":"10.13039\/501100003399","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Obstet Gynecol Scand"],"published-print":{"date-parts":[[2023,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Tranexamic acid reduces blood loss and allogeneic transfusion requirements in various surgical procedures. The role of tranexamic acid during cytoreductive procedures in advanced ovarian cancer is not clear.<\/jats:p><\/jats:sec><jats:sec><jats:title>Material and methods<\/jats:title><jats:p>This was a single center randomized, controlled, three\u2010armed clinical trial. A total of 150 ovarian cancer patients undergoing cytoreductive surgery were recruited and assigned to three groups (<jats:italic>n<\/jats:italic>\u2009=\u200950\/group): the control group (normal saline), low\u2010dose group (10\u2009mg\/kg bolus\u2009+\u20091\u2009mg\/kg continuous infusion of tranexamic acid), and high\u2010dose group (20\u2009mg\/kg bolus\u2009+\u20095\u2009mg\/kg continuous infusion of tranexamic acid). The primary endpoint was intraoperative blood loss volume and total blood loss volume, and secondary endpoints included intraoperative blood transfusion volumes, vasoactive agent consumption, admission into the intensive care unit, and incidence of postoperative complications within postoperative 30\u2009days. The study was registered at <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"http:\/\/clinicaltrials.gov\">ClinicalTrials.gov<\/jats:ext-link> ID: NCT04360629.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The patients in the high\u2010dose group had less intraoperative (median [IQR]: 625.3\u2009mL [343.5\u20131210.5]) and total blood loss volume (748.9\u2009mL [292.2\u20131650.2]) than those in the control group (1015.5\u2009mL [679.4\u20131015.5], <jats:italic>p<\/jats:italic>\u2009=\u20090.012; and 1700.7\u2009mL [458.7\u20132419.8], <jats:italic>p<\/jats:italic>\u2009=\u20090.004, respectively). In contrast, the intraoperative (992.5\u2009mL [539.0\u20131404.0], <jats:italic>p<\/jats:italic>\u2009=\u20090.874) and total blood loss volume (1025.0\u2009mL [381.8\u20131819.9], <jats:italic>p<\/jats:italic>\u2009=\u20090.113) was not significantly reduced in the low\u2010dose group when compared with the control group. Correspondingly, the relative risk of blood transfusion (RR [95% CI], 0.405 [0.180\u20130.909], <jats:italic>p<\/jats:italic>\u2009=\u20090.028) was reduced in the high\u2010dose group and required less intraoperative noradrenaline (881.0\u2009\u00b1\u2009438.3\u2009mg) to maintain stable hemodynamics than the control group (1548.0\u2009\u00b1\u2009349.8\u2009mg, <jats:italic>p<\/jats:italic>\u2009=\u20090.001). Furthermore, compared with the control group, the two tranexamic acid groups had decreased intensive care unit admission rates (<jats:italic>p<\/jats:italic>\u2009=\u20090.016) without increasing the incidence of postoperative seizure, acute kidney injury, and thromboembolism.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>High\u2010dose tranexamic acid is more effective in reducing blood loss and blood transfusion without increasing the risk of postoperative complications. The high\u2010dose regime tended to have a better risk\u2013benefit profile.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aogs.14567","type":"journal-article","created":{"date-parts":[[2023,4,8]],"date-time":"2023-04-08T03:25:42Z","timestamp":1680924342000},"page":"950-959","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Intraoperative use of tranexamic acid to reduce blood loss during cytoreductive surgery for advanced ovarian cancer: A randomized controlled clinical trial"],"prefix":"10.1111","volume":"102","author":[{"given":"Xijun","family":"Yang","sequence":"first","affiliation":[{"name":"Department of Anesthesiology Fudan University Shanghai Cancer Center  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mao","family":"Chai","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology Fudan University Shanghai Cancer Center  Shanghai 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