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Wahb, Mohamed, Elghouneimy, Mohamed, Qandeel, Miqdad, Elrefae, Abdullah, Khater, Mohamed H., Mashhour, Mirna Morad, Seif, Ali Mohamed, Seddek, Mohammad Amgad, Abdelwahab, Omar Ahmed. (1404). Efficacy and Safety of Combined Carbazochrome Sodium Sulfonate and Tranexamic Acid for Blood Loss Control in Patients Undergoing Total Hip Arthroplasty: A Systematic Review and Meta-Analysis. سامانه مدیریت نشریات علمی, 51(3), 160-174. doi: 10.30476/ijms.2025.106924.4124
Mohamed Wahb; Mohamed Elghouneimy; Miqdad Qandeel; Abdullah Elrefae; Mohamed H. Khater; Mirna Morad Mashhour; Ali Mohamed Seif; Mohammad Amgad Seddek; Omar Ahmed Abdelwahab. "Efficacy and Safety of Combined Carbazochrome Sodium Sulfonate and Tranexamic Acid for Blood Loss Control in Patients Undergoing Total Hip Arthroplasty: A Systematic Review and Meta-Analysis". سامانه مدیریت نشریات علمی, 51, 3, 1404, 160-174. doi: 10.30476/ijms.2025.106924.4124
Wahb, Mohamed, Elghouneimy, Mohamed, Qandeel, Miqdad, Elrefae, Abdullah, Khater, Mohamed H., Mashhour, Mirna Morad, Seif, Ali Mohamed, Seddek, Mohammad Amgad, Abdelwahab, Omar Ahmed. (1404). 'Efficacy and Safety of Combined Carbazochrome Sodium Sulfonate and Tranexamic Acid for Blood Loss Control in Patients Undergoing Total Hip Arthroplasty: A Systematic Review and Meta-Analysis', سامانه مدیریت نشریات علمی, 51(3), pp. 160-174. doi: 10.30476/ijms.2025.106924.4124
Wahb, Mohamed, Elghouneimy, Mohamed, Qandeel, Miqdad, Elrefae, Abdullah, Khater, Mohamed H., Mashhour, Mirna Morad, Seif, Ali Mohamed, Seddek, Mohammad Amgad, Abdelwahab, Omar Ahmed. Efficacy and Safety of Combined Carbazochrome Sodium Sulfonate and Tranexamic Acid for Blood Loss Control in Patients Undergoing Total Hip Arthroplasty: A Systematic Review and Meta-Analysis. سامانه مدیریت نشریات علمی, 1404; 51(3): 160-174. doi: 10.30476/ijms.2025.106924.4124

Efficacy and Safety of Combined Carbazochrome Sodium Sulfonate and Tranexamic Acid for Blood Loss Control in Patients Undergoing Total Hip Arthroplasty: A Systematic Review and Meta-Analysis

Iranian Journal of Medical Sciences
مقاله 2، دوره 51، شماره 3، خرداد 2026، صفحه 160-174    اصل مقاله (2.44 M)
نوع مقاله: Review Article
شناسه دیجیتال (DOI): 10.30476/ijms.2025.106924.4124
نویسندگان
Mohamed Wahb* 1؛ Mohamed Elghouneimy2؛ Miqdad Qandeel3؛ Abdullah Elrefae3؛ Mohamed H. Khater4؛ Mirna Morad Mashhour5؛ Ali Mohamed Seif6؛ Mohammad Amgad Seddek6؛ Omar Ahmed Abdelwahab6
1Kettering General Hospital NHS Foundation Trust; Kettering, England
2Manchester University NHS Foundation Trust, Manchester, England, United Kingdom
3Northwick Park Hospital, Harrow, England, United Kingdom
4Obstetrics and Gynaecology Specialty Trainee, Diana Princess of Wales Hospital, Grimsby, United Kingdom
5Internal Medicine Fellowship Trainee, Benha Health Insurance Hospital, Banha, Egypt
6Faculty of Medicine, Al‐Azhar University, Cairo, Egypt
چکیده
Background: Total hip arthroplasty (THA) relieves pain and restores function in severe hip arthritis and other painful hip disorders. THA is successful; however, it involves significant perioperative blood loss, which can lead to complications and economic burden. Tranexamic acid (TXA) reduces blood loss. However, its impact on hidden blood loss (HBL) is uncertain. The hemostatic effect of TXA may be enhanced by carbazochrome sodium sulphate (CSS). This study aimed to evaluate the safety and efficacy of combined CSS and TXA in reducing blood loss in THA.
Methods: This systematic review and meta-analysis was conducted in accordance with the Cochrane Handbook and PRISMA guidelines. We included randomized controlled trials comparing CSS+TXA versus TXA alone in patients undergoing primary THA. Four electronic databases (MEDLINE via PubMed, Scopus, Web of Science, and Cochrane Central Register of Controlled Trials) were searched from inception to 22 May 2024 without language restrictions. The risk of bias was assessed using the Cochrane ROB2 tool. Data were synthesized using mean difference (MD) or relative risk (RR) with 95% confidence intervals. Fixed- or random-effects models were applied based on the level of heterogeneity. Outcomes assessed included total (TBL), hidden (HBL), and intraoperative blood loss (IBL); mean hemoglobin (Hb) reduction; inflammatory markers; visual analogue scale (VAS) pain levels; hospital stay; transfusion rates; and complications. 
Results: This analysis included 450 participants from three studies. The meta-analysis revealed that the CSS+TXA group had significantly lower TBL (MD=-270.23 mL; P<0.001) and HBL (MD=-269.09 mL; P<0.001) than the TXA+Placebo group. However, there was no significant difference in IBL (MD=-82 mL; P=0.61). The CSS+TXA group had a lower transfusion rate (RR=0.10; P=0.006). Mean Hb reduction, hospital stay, and operation time were not significantly different. CSS+TXA also significantly reduced postoperative VAS pain and inflammatory markers. There was no increase in thromboembolic events or other complications.
Conclusion: The combination of CSS and TXA reduces postoperative blood loss, pain, and inflammation in patients undergoing THA, without increasing complications. Further research is required to validate these findings in larger, more diverse populations, and to determine optimal dosing and long-term outcomes.

تازه های تحقیق

Mohamed Wahb (Google Scholar) 

کلیدواژه‌ها
Antifibrinolytic agents؛ Total hip arthroplasty؛ Carbazochrome؛ Tranexamic acid
سایر فایل های مرتبط با مقاله
مراجع
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