TXA is not just for trauma, maybe…

This one comes not from our annals but it is interesting.

Patients with UGIB can be very unstable and getting control of that bleeding is a key factor in keeping them alive.

Here is a SR that provides evidence that TXA reduces mortality in these patients.

Compelling given the low complication rates with TXA seen in the CRASH-2 study.

If you want to read a bit more there is a Cochran review by the same group.

The studies included are not great but the HALT trial (read here) is in progress so we should see some better data in the future.

TXA might be moving into that realm of panacea therapies where Mag, ketamine and NIV live?

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2 comments for “TXA is not just for trauma, maybe…

  1. LGrodin
    February 12, 2015 at 1:14 pm

    Two things I recently learned about tranexamic acid (besides how to pronounce it) while I was poking around for ideas about how to control a bleeding hemodialysis shunts and grafts:
    1. TXA is on the WHO Model List Essential Medicines” indicating it is needed for a basic health‐care system, and among the most efficacious, safe and cost‐effective medicines for priority conditions
    2. TXA was used many decades ago in OBGYN, a specialty we don’t give much credit often but seems was the first to use it. So while it’s not just for trauma, it never was! There’s a New York Times article from 2012 discussing on how slow the medical field is to adopt these things.

    For me as a junior especially, I just want to state way more hemorrhaging patients have been saved by large bore IV lines than tranexamic acid, octreodide, PPIs, or many other things that are fun and fascinating to discus.

  2. Ian deSouza
    February 12, 2015 at 2:31 pm

    Also…..

    A new and rapid method for epistaxis treatment using injectable form of tranexamic
    acid topically: a randomized controlled trial. American Journal of Emergency Medicine 31 (2013) 1389–1392.
    http://dx.doi.org/10.1016/j.ajem.2013.06.043

    (Interesting editorial comment at the end there, Grodin.)

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