9,535
Participants
Start Date
June 27, 2018
Primary Completion Date
November 8, 2021
Study Completion Date
February 3, 2023
Tranexamic Acid
Within 20 minutes preceding the anticipated skin incision, patients will receive intravenous TXA at a loading dose of 1g over 10 minutes, with a second 1g bolus given at the end of surgery when closing the wound.
Placebo (Saline)
Within 20 minutes preceding the anticipated skin incision, patients will receive intravenous placebo (0.9% normal saline) at a loading dose of 1g over 10 minutes, with a second 1g bolus given at the end of surgery when closing the wound.
Perioperative hypotension-avoidance strategy
"Perioperative hypotension-avoidance strategy includes:~1. Preoperative algorithm that only continues some antihypertensive medications in a stepwise manner for systolic BP ≥130 mm Hg before surgery,~2. Intraoperative blood pressure targeting a mean arterial pressure (MAP) ≥80 mm Hg~3. Postoperative algorithm that only continues some antihypertensive medications in a stepwise manner for systolic BP ≥130 mm Hg during the first 48 hours after surgery."
Perioperative hypertension-avoidance strategy
Perioperative hypertension-avoidance strategy (i.e., routine care) continues all antihypertensive drugs before and after surgery and an intraoperative BP strategy targeting a MAP ≥60 mm Hg.
Queen Elizabeth II Jubilee Hospital, Brisbane
Columbia University, New York
Wake Forest, Winston-Salem
Cleveland Clinic, Florida, Weston
The Ohio State University Wexner Medical Center, Columbus
Cleveland Clinic - Fairview, Cleveland
Cleveland Clinic - Hillcrest, Mayfield Heights
Cleveland Clinic - Main Campus, Cleveland
MD Anderson Cancer Center, Houston
Oregon Health & Science University, Portland
V. Negovskiy Reanimatology Research Institute, Moscow
Government Medical College, Trivandrum
NH Rabindranath Tagore International Inst. of Cardiac Sciences, Kolkata
Yale New Haven Hospital, New Haven
University of North Carolina at Chapel Hill, Chapel Hill
Rhode Island Hospital, Providence
Princess Alexandra Hospital, Woolloongabba
Royal Adelaide Hospital, Adelaide
Flinders Medical Centre, Bedford Park
Royal Hobart Hospital, Hobart
Eastern Health (Box Hill Hospital), Box Hill
Dandenong Hospital, Dandenong
Austin Hospital, Heidelberg
Royal Melbourne Hospital, Parkville
Fiona Stanley Hospital, Murdoch
Western Health, Footscray
Peter MacCallum Hospital, Melbourne
John Hunter Hospital, New Lambton
Royal Perth, Perth
Princes of Wales Hospital, Randwick
Goulburn Valley Health, Shepparton
Westmead Hospital, Sydney
Medical University of Vienna, Vienna
CHU Brugmann, Brussels
Cliniques Universitaires Saint-Luc, Brussels
Hospital do Coracao de Pocos de Caldas, Poços de Caldas
Hospital de Clinicas de Porto Alegre, Porto Alegre
University of Calgary, O'Brien Institute for Public Health, Calgary
University of Alberta, Edmonton
Health Sciences Centre, Winnipeg
Kingston Health Sciences Centre, Kingston
University Health Network (Toronto General Hospital), Toronto
CHUM, Montreal
Sherbrooke, Sherbrooke
Royal University Hospital (Saskatoon), Saskatoon
Victoria Hospital, London
Clinica Santa Maria, Santiago
Hospital Hernan Henriquez, Temuco
Second Hospital of Anhui Medical University, Hefei
Shenzhen People's Hospital, Shenzhen
The Fourth Affiliated Hospital of Harbin Medical University, Harbin
West China Hospital of Sichuan University, Chengdu
Bispebjerg Hospital, Copenhagen
Rigshospitalet, Abdominal Centre, Copenhagen
Zealand University Hospital, Køge
Groupe Hospitalier Paris Saint Joseph, Paris
University Hospital RWTH Aachen, Aachen
University Hospital Bonn, Bonn
Klinikum Dortmund gGmbH, Dortmund
University Hospital Düsseldorf, Düsseldorf
Prince of Wales Hospital, Shatin
Surat Institute of Digestive Science, Surat
Sumandeep Vidyapeeth & Dhiraj General Hospital, Vadodara
Nanjappa Hospital, Shimoga
Rahate Surgical Hospital, Nagpur
Sengupta Hospital & Research Institute, Nagpur
AMAI Charitable Trust's Ace Hospital, Pune
Sidhu Hospital Pvt. Ltd., Dorāha
Christian Medical College, Ludhiana, Ludhiana
Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Lucknow
TD Medical College, Alappuzha
Bangalore Baptist Hospital, Bangalore
Ospedale Galliera di Genova, Genova
Instituto Clinico San Siro, Milan
IRCCS San Raffaele Scientific Institute, Milan
IRCCS Galeazzi Orthopedic Institute, Milan
Port Dickson Hospital, Port Dickson
Sarawak General Hospital, Kuching
Hospital Kuala Lumpur, Kuala Lumpur
University Malaya Medical Centre, Kuala Lumpur
Hospital Pulau Pinang, Pulau Pinang
Sungai Buloh Hospital, Sungai Buloh
Deventer Ziekenhuis, Deventer
Erasmus University Medical Center, Rotterdam
Auckland General Hospital, Grafton
Middlemore Hospital, Auckland
Waikato District Health Board, Hamilton
Shifa International Hospitals, Islamabad
Aga Khan University, Karachi
Jagiellonian University Medical College, Krakow
Specialistyczny Szpital im. E. Szczeklika w Tarnowie, Tarnów
Szpital Uniwersytecki im Karola Marcinkowskiego w Zielonej Górze, Zielona Góra
City Hospital 1 of Arkhangelsk, Arkhangelsk
Moscow Regional Research & Clinical Institute (MONIKI), Moscow
City Hospital N25, Novosibirsk
E. Meshalkin National Medical Research Center, Novosibirsk
Hospital of Saint-Petersburg State University, Saint Petersburg
Tyumen State Medical University, Tyumen
Groote Schuur Hospital, Observatory
Sefako Makgatho Health Sciences University (SMU), Ga-Rankuwa
Steve Biko Academic Hospital - University of Pretoria, Pretoria
Hospital Clinic - Barcelona, Barcelona
Hospital de la Sta Creu i Sant Pau, Barcelona
Hospital Vall D'Hebron, Barcelona
Hospital Dr. Josep Trueta, Girona
Hospital Ramon y Cajal, Madrid
Hospital Universitario Fundacion Alcorcon, Madrid
Hospital Clínico Universitario in Valladolid, Valladolid
Medway NHS Foundation Trust, Gillingham
Chelsea & Westminster Hospital, London
West Middlesex Hospital, London
Hamilton General Hospital, Hamilton
St. Joseph's Healthcare Hamilton, Hamilton
Juravinski Hospital & Cancer Centre, Hamilton
Lead Sponsor
Population Health Research Institute
OTHER