Tranexamic Acid Update in Trauma

Ricardo J Ramirez; Philip C Spinella; Grant V Bochicchio

doi:10.1016/j.ccc.2016.08.004

Tranexamic Acid Update in Trauma

Crit Care Clin. 2017 Jan;33(1):85-99. doi: 10.1016/j.ccc.2016.08.004.

Authors

Ricardo J Ramirez¹, Philip C Spinella², Grant V Bochicchio³

Affiliations

¹ Department of Surgery, Washington University School of Medicine, 660 South Euclid Avenue, St Louis, MO 63110, USA.
² Department of Pediatrics, Washington University School of Medicine, St Louis, MO, USA.
³ Department of Surgery, Washington University School of Medicine, 660 South Euclid Avenue, St Louis, MO 63110, USA. Electronic address: bochicchiog@wudosis.wustl.edu.

PMID: 27894501
DOI: 10.1016/j.ccc.2016.08.004

Abstract

Following results from the CRASH-2 trial, tranexamic acid (TXA) gained considerable interest for the treatment of hemorrhage in trauma patients. Although TXA is effective at reducing mortality in patients presenting within 3 hours of injury, optimal dosing, timing of administration, mechanism, and pharmacokinetics require further elucidation. The concept of fibrinolysis shutdown in hemorrhagic trauma patients has prompted discussion of real-time viscoelastic testing and its potential role for appropriate patient selection. The results of ongoing clinical trials will help establish high-quality evidence for optimal incorporation of TXA in mature trauma networks in the United States and abroad.

Keywords: Antifibrinolytics; Coagulopathy; Hemorrhage; Surgery; Tranexamic acid; Trauma.

Publication types

Review

MeSH terms

Antifibrinolytic Agents / therapeutic use*
Hemorrhage / drug therapy*
Humans
Tranexamic Acid / therapeutic use*
Wounds and Injuries / diagnosis*
Wounds and Injuries / drug therapy*

Substances

Antifibrinolytic Agents
Tranexamic Acid