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Advances in Anesthesia Dec 2023Tranexamic acid is a well-known antifibrinolytic that has numerous clinical indications, and it is efficacious and safe in many perioperative scenarios including... (Review)
Review
Tranexamic acid is a well-known antifibrinolytic that has numerous clinical indications, and it is efficacious and safe in many perioperative scenarios including patients with some thrombotic risks. However, further studies that characterize clinical outcomes concerning dosing, timing, and routes in combination are needed in ultra high-risk populations.
Topics: Humans; Tranexamic Acid; Orthopedic Procedures; Orthopedics; Antifibrinolytic Agents
PubMed: 38251612
DOI: 10.1016/j.aan.2023.05.001 -
Seminars in Thrombosis and Hemostasis Jul 2022Tranexamic acid (TXA) is an antifibrinolytic drug primarily used for reducing blood loss in patients with major bleedings. Animal and cell studies have shown that TXA...
Tranexamic acid (TXA) is an antifibrinolytic drug primarily used for reducing blood loss in patients with major bleedings. Animal and cell studies have shown that TXA might modulate the inflammatory response by either enhancing or inhibiting cytokine levels. Furthermore, recent human studies have found altered inflammatory biomarkers in patients receiving TXA when compared with patients who did not receive TXA. In this systematic review we investigated the effect of TXA on inflammatory biomarkers in different patient groups. A systematic literature search was conducted on the databases PubMed and Embase to identify all original articles that investigated inflammatory biomarkers in patients receiving TXA and compared them to a relevant control group. The review was performed according to the PRISMA guidelines, and the literature search was performed on November 29, 2021. Thirty-three studies were included, among which 14 studies compared patients receiving TXA with patients getting no medication, another 14 studies investigated different dosing regimens of TXA, and finally five studies examined the administration form of TXA. The present review suggests that TXA has an anti-inflammatory effect in patients undergoing orthopaedic surgery illustrated by decreased levels of C-reactive protein and interleukin-6 in patients receiving TXA compared with patients receiving no or lower doses of TXA. However, the anti-inflammatory effect was not found in patients undergoing cardiac surgery, pediatric craniosynostosis patients, or in rheumatoid arthritis patients. The inflammatory response was not affected by administration form of TXA (oral, intravenous, or topical). In conclusion, an anti-inflammatory effect of TXA was consistently found among orthopaedic patients only.
Topics: Anti-Inflammatory Agents; Antifibrinolytic Agents; Arthroplasty, Replacement, Knee; Blood Loss, Surgical; Child; Humans; Tranexamic Acid
PubMed: 35636449
DOI: 10.1055/s-0042-1742741 -
Drug and Therapeutics Bulletin Jun 2021The HALT-IT Trial Collaborators. Effects of a high-dose 24-h infusion of tranexamic acid on death and thromboembolic events in patients with acute gastrointestinal... (Randomized Controlled Trial)
Randomized Controlled Trial
The HALT-IT Trial Collaborators. Effects of a high-dose 24-h infusion of tranexamic acid on death and thromboembolic events in patients with acute gastrointestinal bleeding (HALT-IT): an international randomised, double-blind, placebo-controlled trial. 2020; 395:1927-36.
Topics: Antifibrinolytic Agents; Double-Blind Method; Gastrointestinal Hemorrhage; Humans; Thromboembolism; Tranexamic Acid
PubMed: 33753352
DOI: 10.1136/dtb.2021.000016 -
Revista Espanola de Anestesiologia Y... May 2021Recently, it has been suggested that tranexamic acid should be administered only in those patients with hyperfibrinolysis determined using viscoelastic assays, as...
Recently, it has been suggested that tranexamic acid should be administered only in those patients with hyperfibrinolysis determined using viscoelastic assays, as severely injured patients may present with fibrinolytic shutdown. However the last European guidelines on management of major bleeding and coagulopathy following trauma endorse the use of tranexamic acid to the trauma patient who is bleeding or at risk of significant hemorrhage as soon as possible without waiting for viscoelastic results. We present a severely blunt trauma patient treated with on-scene administration of tranexamic acid that developed immediate pulmonary embolism.
Topics: Antifibrinolytic Agents; Blood Coagulation Disorders; Fibrinolysis; Hemorrhage; Humans; Tranexamic Acid
PubMed: 34140128
DOI: 10.1016/j.redare.2020.06.016 -
Emergencias : Revista de La Sociedad... Feb 2021
Topics: Antifibrinolytic Agents; Clinical Trials as Topic; Craniocerebral Trauma; Hemorrhage; Humans; Tranexamic Acid
PubMed: 33496410
DOI: No ID Found -
Annals of Emergency Medicine Aug 2019
Comparative Study Meta-Analysis
Topics: Administration, Oral; Administration, Topical; Antifibrinolytic Agents; Epistaxis; Hemorrhage; Humans; Randomized Controlled Trials as Topic; Tranexamic Acid
PubMed: 31060746
DOI: 10.1016/j.annemergmed.2019.01.042 -
Emergency Medicine Australasia : EMA Oct 2020
Topics: Antifibrinolytic Agents; Hemorrhage; Humans; Tranexamic Acid
PubMed: 32975027
DOI: 10.1111/1742-6723.13629 -
CJEM Feb 2024
Topics: Humans; Tranexamic Acid; Antifibrinolytic Agents; Emergency Medical Services; Wounds and Injuries
PubMed: 38233577
DOI: 10.1007/s43678-023-00642-8 -
The Annals of Pharmacotherapy Jan 2012To evaluate the literature describing topical use of tranexamic acid or aminocaproic acid for prevention of postoperative bleeding after major surgical procedures. (Review)
Review
OBJECTIVE
To evaluate the literature describing topical use of tranexamic acid or aminocaproic acid for prevention of postoperative bleeding after major surgical procedures.
DATA SOURCES
Literature was retrieved through MEDLINE (1946-September 2011) and International Pharmaceutical Abstracts (1970-September 2011) using the terms tranexamic acid, aminocaproic acid, antifibrinolytic, topical, and surgical. In addition, reference citations from publications identified were reviewed.
STUDY SELECTION AND DATA EXTRACTION
All identified articles in English were evaluated. Clinical trials, case reports, and meta-analyses describing topical use of tranexamic acid or aminocaproic acid to prevent postoperative bleeding were included.
DATA SYNTHESIS
A total of 16 publications in the setting of major surgical procedures were included; the majority of data were for tranexamic acid. For cardiac surgery, 4 trials used solutions containing tranexamic acid (1-2.5 g in 100-250 mL of 0.9% NaCl), and 1 trial assessed a solution containing aminocaproic acid (24 g in 250 mL of 0.9% NaCl). These solutions were poured into the chest cavity before sternotomy closure. For orthopedic procedures, all of the data were for topical irrigation solutions containing tranexamic acid (500 mg-3 g in 50-100 mL of 0.9% NaCl) or for intraarticular injections of tranexamic acid (250 mg to 2 g in 20-50 mL of 0.9% sodium chloride, with or without carbazochrome sodium sulfate). Overall, use of topical tranexamic acid or aminocaproic acid reduced postoperative blood loss; however, few studies reported a significant reduction in the number of packed red blood cell transfusions or units given, intensive care unit stay, or length of hospitalization.
CONCLUSIONS
Topical application of tranexamic acid and aminocaproic acid to decrease postsurgical bleeding after major surgical procedures is a promising strategy. Further data are needed regarding the safety of this hemostatic approach.
Topics: Administration, Topical; Aminocaproates; Antifibrinolytic Agents; Cardiac Surgical Procedures; Clinical Trials as Topic; Humans; Orthopedic Procedures; Postoperative Hemorrhage; Practice Guidelines as Topic; Tranexamic Acid
PubMed: 22202494
DOI: 10.1345/aph.1Q383 -
Current Opinion in Hematology Nov 2018We review recent articles pertaining to the use of tranexamic acid (TXA) in populations at risk for massive transfusion. Although there are no recent studies that... (Review)
Review
PURPOSE OF REVIEW
We review recent articles pertaining to the use of tranexamic acid (TXA) in populations at risk for massive transfusion. Although there are no recent studies that specifically examine the use of TXA in massive transfusion protocols (MTPs), there are a few studies with subgroups of massive transfusion patients.
RECENT FINDINGS
In recent years, many publications have discussed outcomes and safety associated with the addition of TXA to treatment plans for bleeding pediatric, trauma, and postpartum hemorrhage patients. In general, TXA appears to decrease mortality and transfusion requirements.
SUMMARY
TXA was shown to decrease mortality in several bleeding populations. It is now a common addition to MTPs. There is conflicting evidence regarding the potential of TXA as a risk factor for thrombotic events. Ongoing studies should provide additional evidence regarding the thrombotic risk of TXA in massive transfusion.
Topics: Antifibrinolytic Agents; Blood Transfusion; Humans; Thrombosis; Tranexamic Acid
PubMed: 30124475
DOI: 10.1097/MOH.0000000000000457