Tranexamic acid: still far to go

<span class="paragraphSection">Tranexamic acid (TXA), a synthetic lysine analogue, is a potent antifibrinolytic agent that inhibits both plasminogen and plasmin. Tranexamic acid gained worldwide recognition in the 2010 Clinical Randomization of an Antifibrinolytic in Significant Hemorrhage (CRASH- 2) trial, a multinational randomized placebo-controlled trial of TXA in adult trauma patients with significant bleeding.<a href="#aew470-B1" class="reflinks"><sup>1</sup></a> TXA significantly reduced the risk of death as a result of bleeding by about a sixth and reduced the risk of all cause mortality by about a tenth. In 2011, TXA was recommended by the World Health Organization as an essential medicine for the treatment of acute bleeding in patients with trauma, cardiopulmonary bypass or postpartum haemorrhage.<a href="#aew470-B2" class="reflinks"><sup>2</sup></a> The 2013 European guidelines recommended TXA in the prophylactic treatment of bleeding in major surgery to reduce perioperative blood loss and allogeneic blood transfusion.<a href="#aew470-B3" class="reflinks"><sup>3</sup></a> The 2015 ASAs practice guidelines for perioperative blood management recommended consideration of TXA in surgical patients with excessive bleeding.<a href="#aew470-B4" class="reflinks"><sup>4</sup></a> Tranexamic acid has consistently been shown to play an important role in blood conservation and ...
Source: British Journal of Anaesthesia - Category: Anesthesiology Source Type: research