open access

Vol 7, No 1 (2022)
Review paper
Published online: 2022-03-18
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Tranexamic acid use in emergency medicine

Mahdi Al-Jeabory12, Wladyslaw Gawel2, Aleksandra Gasecka3, Lukasz Szarpak145, Wojciech Wieczorek16
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Disaster Emerg Med J 2022;7(1):47-51.
Affiliations
  1. Reseach Unit, Polish Society of Disaster Medicine, Warsaw, Poland
  2. Research Unit, Polonia University, Czestochowa, Poland
  3. 1st Chair and Department of Cardiology, Medical University of Warsaw, Warsaw, Poland
  4. Henry JN Taub Department of Emergency Medicine, Baylor College of Medicine, Houston, TX, USA
  5. Institute of Outcomes Research, Maria Sklodowska-Curie Medical Academy, Warsaw, Poland
  6. Department of Emergency Medicine, Medical University of Warsaw, Warsaw, Poland

open access

Vol 7, No 1 (2022)
REVIEW ARTICLES
Published online: 2022-03-18

Abstract

The most common cause of potentially preventable trauma deaths is hemorrhage. Therefore, it is crucial to understand the mechanisms regulating bleeding and clotting. The physiological mechanisms that control the coagulation process are called the coagulation cascade. In this study, we analyzed the medical literature for published articles on the use of TXA for bleeding. The MEDLINE electronic database was searched for. The keywords we have used were: “tranexamic acid”, “bleeding”, “hemorrhage”, “treatment”, “prevention”, “patient blood management”, “anti-fibrinolytic”, “surgery”, “surgery”, “trauma”, “injury” and “traumatic brain injury”. When managing the traumatic patient, time is of the essence and the same holds true for the TXA application. The largest study regarding the use of TXA in the emergency medicine CRASH-2 found that the administration of TXA within 3 hours following injury significantly reduces the mortality and that every 15-min delay in administering TXA results in increased bleeding and decreased survival by 10%, offering no benefit if administered after 3 hours. In summary, TXA is a safe and reliable agent which greatly increases the survival rate in traumatic patients suffering blood loss, reducing mortality while being safe.

Abstract

The most common cause of potentially preventable trauma deaths is hemorrhage. Therefore, it is crucial to understand the mechanisms regulating bleeding and clotting. The physiological mechanisms that control the coagulation process are called the coagulation cascade. In this study, we analyzed the medical literature for published articles on the use of TXA for bleeding. The MEDLINE electronic database was searched for. The keywords we have used were: “tranexamic acid”, “bleeding”, “hemorrhage”, “treatment”, “prevention”, “patient blood management”, “anti-fibrinolytic”, “surgery”, “surgery”, “trauma”, “injury” and “traumatic brain injury”. When managing the traumatic patient, time is of the essence and the same holds true for the TXA application. The largest study regarding the use of TXA in the emergency medicine CRASH-2 found that the administration of TXA within 3 hours following injury significantly reduces the mortality and that every 15-min delay in administering TXA results in increased bleeding and decreased survival by 10%, offering no benefit if administered after 3 hours. In summary, TXA is a safe and reliable agent which greatly increases the survival rate in traumatic patients suffering blood loss, reducing mortality while being safe.

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Keywords

tranexamic acid; TXA; bleeding; emergency medicine; trauma

About this article
Title

Tranexamic acid use in emergency medicine

Journal

Disaster and Emergency Medicine Journal

Issue

Vol 7, No 1 (2022)

Article type

Review paper

Pages

47-51

Published online

2022-03-18

Page views

5015

Article views/downloads

594

DOI

10.5603/DEMJ.a2022.0006

Bibliographic record

Disaster Emerg Med J 2022;7(1):47-51.

Keywords

tranexamic acid
TXA
bleeding
emergency medicine
trauma

Authors

Mahdi Al-Jeabory
Wladyslaw Gawel
Aleksandra Gasecka
Lukasz Szarpak
Wojciech Wieczorek

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