Rationale and design of the PeriOperative ISchemic Evaluation-3 (POISE-3): a randomized controlled trial evaluating tranexamic acid and a strategy to minimize hypotension in noncardiac surgery

• Main Authors: Samuel Ern Hung, Tsan, Marcucci, Maura, Painter, Thomas W., Conen, David, Leslie, Kate, Lomivorotov, Vladimir, Sessler, David, Chan, Matthew T. V
• Format: Article
• Language: English; English
• Published: Springer Nature , BioMed Central Ltd 2022
• Subjects: R Medicine (General); RD Surgery
• Online Access: http://ir.unimas.my/id/eprint/38380/1/Marcucci%202022.pdf; http://ir.unimas.my/id/eprint/38380/2/Marcucci%202022%20Appendix%2010.docx; http://ir.unimas.my/id/eprint/38380/; https://trialsjournal.biomedcentral.com/articles/10.1186/s13063-021-05992-1

Background: For patients undergoing noncardiac surgery, bleeding and hypotension are frequent and associated with increased mortality and cardiovascular complications. Tranexamic acid (TXA) is an antifibrinolytic agent with the potential to reduce surgical bleeding; however, there is uncertainty about its efficacy and safety in noncardiac surgery. Although usual perioperative care is commonly consistent with a hypertension-avoidance strategy (i.e., most patients continue their antihypertensive medications throughout the perioperative period and intraoperative mean arterial pressures of 60 mmHg are commonly accepted), a hypotension-avoidance strategy may improve perioperative outcomes.