Discussion

DR JOHN SANTANIELLO (Oak Lawn, IL): The CRASH II and MATTERs trials established that tranexamic acid (TXA) benefits patients with hemorrhage in a select cohort, namely, those with fibrinolysis ≥3% on a rapid thrombelastography (TEG). Tranexamic acid did reduce mortality in CRASH II, but it was unclear whether it was due to prevention of clot lysis and improved coagulation with decreased bleeding, because there was no statistical difference in RBC transfusion in those groups. Because TXA inhibits plasmin, it has been speculated that improved survival may be caused by an attenuated inflammatory response by inhibiting its proinflammatory effects.
Source: Journal of the American College of Surgeons - Category: Surgery Tags: Western surgical association article Source Type: research