Tranexamic acid in trauma: How should we use it?

@article{Napolitano2013TranexamicAI,
  title={Tranexamic acid in trauma: How should we use it?},
  author={L. Napolitano and M. Cohen and B. Cotton and M. Schreiber and E. Moore},
  journal={Journal of Trauma and Acute Care Surgery},
  year={2013},
  volume={74},
  pages={1575–1586}
}
T CRASH-2 trial results have prompted trauma centers to contemplate whether tranexamic acid (TXA) should be added to their armamentarium for the treatment of bleeding trauma patients. Primary fibrinolysis is integral in the pathogenesis of the acute coagulopathy of trauma (ACOT). Furthermore, some studies have documented that the risk of death in trauma correlates significantly with fibrinolysis. The presence of hyperfibrinolysis (HF) in patients with severe traumatic injuries is associated… Expand
Tranexamic acid in trauma: how should we use it?
  • I. Roberts
  • Medicine
  • Journal of thrombosis and haemostasis : JTH
  • 2015
TLDR
Results from a multi‐center, randomized, and placebo‐controlled trial showed that TXA safely reduces mortality in bleeding trauma patients, and a clinical trial of TXA in patients with traumatic brain injury is now in progress. Expand
Tranexamic Acid for Trauma Resuscitation in the United States of America
TLDR
A narrative review explores the historical as well as clinical and theoretical grounds for the more measured use of TXA in the United States and proposes a clinical and point‐of‐care guided utilization ofTXA, blood components, and adjunctive hemostatic agents in bleeding trauma patients. Expand
Tranexamic Acid Update in Trauma.
TLDR
Following results from the CRASH-2 trial, tranexamic acid (TXA) gained considerable interest for the treatment of hemorrhage in trauma patients, and optimal dosing, timing of administration, mechanism, and pharmacokinetics require further elucidation. Expand
Tranexamic Acid Use in Prehospital Uncontrolled Hemorrhage.
TLDR
The current literature supports the use of prehospital TXA in the severely injured trauma patient and recommends considering a 1 g TXA bolus en route to definitive care in high-risk patients and withholding subsequent doses until hyperfibrinolysis is confirmed by thromboelastography. Expand
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TLDR
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Severely injured trauma patients with admission hyperfibrinolysis: Is there a role of tranexamic acid? Findings from the PROPPR trial
TLDR
Tranexamic acid was associated with increased 6-hour survival but does not improve long-term outcomes in severely injured trauma patients with hemorrhage who develop hyperfibrinolysis, and further randomized clinical trials will identify the subset of trauma patients who may benefit from TXA. Expand
Safety and Efficacy of Hospital Utilization of Tranexamic Acid in Civilian Adult Trauma Resuscitation
TLDR
A statistically significant reduction in mortality after TXA administration at 28 days is demonstrated, demonstrating the safety and efficacy of TXA in civilian adults hospitalized with traumatic hemorrhagic shock. Expand
Unjustified Administration in Liberal Use of Tranexamic Acid in Trauma Resuscitation.
TLDR
A high rate of unjustified TXA administration is highlighted, especially in the prehospital setting, and Cautious implementation of TXA in resuscitation protocols is encouraged in the meantime. Expand
Compliance of tranexamic acid administration to trauma patients at a level-one trauma centre.
TLDR
Compliance with TXA administration to trauma patients with suspected major bleeding was low and quality improvement strategies aimed at increasing appropriate use of TXA are warranted. Expand
Effects of Tranexamic Acid on Mortality and Blood Transfusion in Trauma Patients with Significant Hemorrhage: A Clinical Trial
TLDR
Tranexamic acid is safe and effective in reducing platelet transfusion rate in patients with trauma-related significant hemorrhage, however, transfusion need and mortality would not reduce by its use in trauma patients. Expand
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The study collaborators sought to evaluate the effect of tranexamic acid on mortality in trauma patients who were actively bleeding or at risk for significant hemorrhage and the incidence of vascular occlusive events and the number of blood transfusions required. Expand
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