Abstract

Tranexamic acid (TXA), a synthetic antifibrinolytic, is an effective adjunct in reducing total blood loss and blood transfusion requirements in the perioperative setting. By inhibiting the activation of plasminogen to plasmin, TXA stabilizes the fibrin matrix of blood clots. This prevents premature fibrinolysis, ultimately minimizing perioperative blood loss and transfusion requirements in surgical populations. In patients undergoing spinal surgery, does the administration of high-dose, intravenous (IV) TXA compared to low-dose TXA reduce blood loss during the perioperative period without increasing risks or side effects? Significant findings in the literature suggest that TXA is effective at reducing perioperative blood losses and blood transfusion requirements, while not increasing risk factors or postoperative side effects.A wide range of dosing regimens were examined in the literature. The overwhelming majority of studies reviewed indicate that HD TXA is more effective than LD regimens at reducing perioperative blood losses and transfusion requirements. However, the greater portion of literature reviewed incorporated unique dosing protocols, making it difficult to distinguish which HD TXA regimen is more favorable. Future research focusing on evidence-based, standardized dosing regimens would be useful to clinical practice. Tranexamic acid is widely used; however, establishing a singular, optimal dosing regimen for all researchers to incorporate into research and practice might facilitate safer implementation and enhance reproducibility of outcomes across research groups.

Author Details

Shelby Smith, BSN, RN, currently enrolled to graduate as a CRNA, DNP on May 1, 2026

Sigma Membership

Non-member

Type

DNP Capstone Project

Format Type

Text-based Document

Study Design/Type

Case Study/Series

Research Approach

Qualitative Research

Keywords:

High Dose Tranexamic Acid, Spine Surgery, Hemorrhage, Surgical Hemostasis, Antifibrinolytic Agents

Advisor

Terri M. Cahoon

Degree

DNP

Degree Grantor

Samford University

Degree Year

2026

Rights Holder

All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record. All permission requests should be directed accordingly and not to the Sigma Repository. All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.

Review Type

None: Degree-based Submission

Acquisition

Proxy-submission

Date of Issue

2026-02-03

Full Text of Presentation

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Download

Available for download on Thursday, February 04, 2027

Click on the above link to access the paper.

Additional Files

Poster.pdf (587 kB)

Abstract.pdf (129 kB)

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