Complicaciones asociadas al uso del ácido tranexámico en el drenaje del hematoma subdural

Abstract

Subdural hematoma (HSD) is a disease characterized by a blood collection located between the dura and arachnoid, linked to risk factors such as age, habits, consumption of anticoagulants and ECT, some of them preventable and modifiable. Tranexamic acid (TXA) is an antifibrinolytic with a strong inhibitory effect on the activation of fibrolisin. In aspects of the treatment of subacute and chronic HSD there are controversies related not only to the surgical procedure but also to the current approach related to the post-surgery therapeutic continuity, due to a multiplicity of intervening factors. Although there are reports of the usefulness of the TXA in HSD, we wish to evaluate factors related to complications due to its use through a prospective, quantitative, observational and descriptive study, with cross-sectional data collected during 9 months. clinical cases of 25 adult patients of both sexes, older than 18 years of age admitted by the Neurosurgery unit. As a result we observed that 76% were free of postoperative complications during their in-hospital stay, in contrast to 24% who presented with a complication: fever, seizures, accidental withdrawal of the pneumocephalus associated drainage system, psychomotor agitation, nosocomial pneumonia and bleeding. At discharge, 64% graduated with complete cure and 36% with some neurological sequel without any demise. In conclusion, the presence of pathological antecedents or psychobiological habits did not represent factors that increase the incidence of complications associated with the use of TXA, on the contrary, demonstrated safety in the treatment of HSD.