{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T13:28:01Z","timestamp":1781875681959,"version":"3.54.5"},"reference-count":40,"publisher":"SAGE Publications","issue":"7","license":[{"start":{"date-parts":[[2024,3,14]],"date-time":"2024-03-14T00:00:00Z","timestamp":1710374400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["The Cleft Palate Craniofacial Journal"],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:p>Craniosynostosis is a congenital condition characterized by the premature closure of one or more sutures in the skull after birth, often necessitating urgent surgical intervention. Nevertheless, cranial vault reconstruction surgery can cause rapid and massive blood loss. This procedure requires a blood transfusion, which entails potential hazards. In addition, the hemostatic system in children differs significantly from that in adults, resulting in increased bleeding during surgical procedures. We conducted a comprehensive literature review in the PubMed, Scopus, and Web of Science databases, referring to their inception for studies on the use of tranexamic acid in pediatric craniosynostosis surgery. Selection criteria were based on the relevance of tranexamic acid, its clinical efficacy, and its safety profile in pediatric populations. Authoritative reviews were considered to ensure a comprehensive synthesis of current knowledge and practice trends in the field. We determined that a low loading dose of 10\u2005mg\/kg followed by a maintenance dose of 5\u2005mg\/kg\/h is as effective as a high dose of 50\u2005mg\/kg followed by a maintenance dose of 10\u2005mg\/kg\/h of tranexamic acid when administered after induction of anesthesia through skin closure and can reduce blood loss by up to 72% and total packed red blood cell transfusion by up to 85%. No difference in safety profile is observed. We concluded that a low dose of tranexamic acid, administered as a loading dose followed by a maintenance dose, is beneficial and safe for reducing blood loss and transfusion following craniosynostosis surgery.<\/jats:p>","DOI":"10.1177\/10556656241239527","type":"journal-article","created":{"date-parts":[[2024,3,14]],"date-time":"2024-03-14T12:44:57Z","timestamp":1710420297000},"page":"1249-1256","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":4,"title":["Tranexamic Acid: Safeguarding Children with Craniosynostosis from Bleeding. A Review Article"],"prefix":"10.1177","volume":"62","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-9507-6380","authenticated-orcid":false,"given":"Khildan Miftahul","family":"Firdaus","sequence":"first","affiliation":[{"name":"Faculty of Medicine, Universitas Airlangga"},{"name":"Department of Anesthesiology and Intensive Care, Universitas Airlangga Hospital, Surabaya City, East Java 60115, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucky","family":"Andriyanto","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Universitas Airlangga"},{"name":"Department of Anesthesiology and Intensive Care, Universitas Airlangga Hospital, Surabaya City, East Java 60115, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-1730-6653","authenticated-orcid":false,"given":"Adil Jihad","family":"Muhammad","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Universitas Airlangga"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tatang","family":"Bisri","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Intensive Care, Dr. Hasan Sadikin Central General Hospital, Bandung City, West Java 40161, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2024,3,14]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.3171\/2021.12.PEDS21532"},{"issue":"2","key":"e_1_3_3_3_2","first-page":"1","article-title":"Calculated blood loss and transfusion requirements in primary open repair of craniosynostosis","volume":"7","author":"Lopez MM","year":"2019","unstructured":"Lopez MM, Lee J, Morrison K, Hoffman C, Souweidane M, Ascherman JA. Calculated blood loss and transfusion requirements in primary open repair of craniosynostosis. Plast Reconstr Surg Glob Open. 2019;7(2):1-5. doi:https:\/\/doi.org\/10.1097\/GOX.0000000000002112","journal-title":"Plast Reconstr Surg Glob Open"},{"key":"e_1_3_3_4_2","article-title":"The developing balance of thrombosis and hemorrhage in pediatric surgery: Clinical implications of age-related changes in hemostasis","volume":"26","author":"Achey MA","unstructured":"Achey MA, Nag UP, Robinson VL, et al. The developing balance of thrombosis and hemorrhage in pediatric surgery: Clinical implications of age-related changes in hemostasis. 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