Tranexamic acid in trauma: how should we use it?. (June 2015)

• Record Type: Journal Article
• Authors: Roberts, I.
• Is Part Of: Journal of thrombosis and haemostasis. Volume 13:(2015:Jan.)Supplement 1
• Page Start: S195
• Page End: S199
• Publication Date: 2015-06
• Subjects: clinical trial -- fibrinolysis -- surgery -- tranexamic acid -- wounds and injuries; Thrombosis -- Periodicals; Hemostasis -- Periodicals; Blood coagulation disorders -- Periodicals; 616.1
• DOI: 10.1111/jth.12878
• Languages: English
• ISSNs: 1538-7933

Abstract

Summary: Tranexamic acid (TXA) reduces blood loss by inhibiting the enzymatic breakdown of fibrin. It is often used in surgery to decrease bleeding and the need for blood transfusion. In 2011, results from a multi‐center, randomized, and placebo‐controlled trial (CRASH‐2 trial) showed that TXA (1 g loading dose over 10 min followed by an infusion of 1 g over 8 h) safely reduces mortality in bleeding trauma patients. Initiation of TXA treatment within 3 h of injury reduces the risk of hemorrhage death by about one‐third, regardless of baseline risk. Because it does not have any serious adverse effects, TXA can be administered to a wide spectrum of bleeding trauma patients. Limiting its use to the most severely injured or those with a diagnosis of 'hyperfibrinolysis' would result in thousands of avoidable deaths. A clinical trial (CRASH‐3 trial) of TXA in patients with traumatic brain injury is now in progress.