2026, Number 2
Use of tranexamic acid in Ewing´s sarcoma resection. Clinical case
Soto-Vargas M, Serrano-Tamayo R
Full text
10.35366/122912
Language: Spanish
References: 5
Page: 130-133
PDF size: 1291.62 Kb.
ABSTRACT
Ewing´s sarcoma most commonly presents between the ages of 11 and 13. It is characterized by a rich vascular supply and requires both clinical and surgical management. Tranexamic acid has been used as pharmacological therapy for hemorrhage control by inhibiting the physiological fibrinolysis system, preventing fibrin degradation and thus providing benefits in anesthetic management. We present the case of a 13-year-old male patient diagnosed with Ewing´s sarcoma of the rib cage, who underwent elective lumpectomy. Borderline permissible bleeding was identified, as preoperative laboratory results showed a hemoglobin level of 10.6 g/dL, with a permissible blood loss of 200 mL; furthermore, it was classified as Johns Hopkins IV (corresponding to a blood loss greater than 1,500 mL) due to the anticipated resection of the rib cage and soft tissues involved with the tumor. It was decided to administer 1 g of tranexamic acid diluted in 100 mL of saline solution, 40 minutes before the start of the surgical procedure, over 10 minutes, with the aim of reducing intra- and postoperative bleeding, as well as promoting greater hemodynamic stability. As a result, intraoperative bleeding was reduced by 53% compared to the prediction based on the Johns Hopkins classification (1,500 mL), accompanied by hemodynamic stability without the need for vasopressors. Scientific evidence related to the use of tranexamic acid has been studied in the field of trauma; however, it is limited in patients undergoing elective surgery. In this context, its use presents a great opportunity, since knowing its benefits allows for its preventive use to avoid the development of coagulopathy and reduce blood loss.REFERENCES