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Positive impact of tranexamic acid in various medical settings
Katarzyna Herjan
Piotr Armański
Jakub Olszewski
Magdalena Sitnik
Maciej Bara
Abstract
The role of successful hemostasis cannot be overemphasized. Bleeding can occur due to various reasons and its cause is not always evident. Any delay in restoring proper hemostasis is associated with an increased risk of complications and therefore results in increased mortality. Discovered in 1962 by Japanese researchers Shosuke and Utako Okamoto, tranexamic acid (TXA) is an anti-fibrinolytic agent that inhibits plasminogen activation by blocking the lysine binding sites on plasminogen. Thanks to its ability to inhibit fibrinolysis it stabilizes the preformed fibrin mesh-work and has a beneficial effect in reducing blood loss in a wide range of clinical settings. TXA has been shown to reduce the risk of perioperative bleeding in patients undergoing noncardiac surgeries. CRASH (Clinical Randomisation of an Antifibrinolytic in Significant Haemorrhage) trials provided the largest body of evidence confirming the effectiveness of early administration of TXA, defined as administration within 3 hours after trauma, in reducing mortality in patients with severe injuries and traumatic brain injury. Recent evidence indicates that TXA administration in the treatment of postpartum hemorrhage results in notable mortality reduction. Topical or locally injected tranexamic acid may reduce blood loss with negligible risk of systemic adverse effects. More high-quality studies are needed to determine safety, efficacy, and dosage. The risk of serious adverse events, especially vascular occlusive events, in patients receiving TXA compared to the placebo group did not differ significantly.
Keywords:
tranexamic acid , antifibrinolytic agents , bleeding , traumaMost read articles by the same author(s)
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