Tranexamic acid: from trauma to routine perioperative use.

Abstract

PURPOSE OF REVIEW:

Optimizing hemostasis with antifibrinolytics is becoming a common surgical practice. Large clinical studies have demonstrated efficacy and safety of tranexamic acid (TXA) in the trauma population to reduce blood loss and transfusions. Its use in patients without pre-existing coagulopathies is debated, as thromboembolic events are a concern. In this review, perioperative administration of TXA is examined in nontrauma surgical populations. Additionally, risk of thromboembolism, dosing regimens, and timing of dosing are assessed.

RECENT FINDINGS:

Perioperative use of TXA is associated with reduced blood loss and transfusions. Thromboembolic effects do not appear to be increased. However, optimal dosing and timing of TXA administration is still under investigation for nontrauma surgical populations.

SUMMARY:

As part of a perioperative blood management programme, TXA can be used to help reduce blood loss and mitigate exposure to blood transfusion.

• Authors: Jeff Simmons, Robert A Sikorski, Jean-Francois Pittet
• Journal: Current opinion in anaesthesiology (Curr Opin Anaesthesiol) Vol. 28 Issue 2 Pg. 191-200 (Apr 2015) ISSN: 1473-6500 [Electronic] United States
• PMID: 25635366 (Publication Type: Journal Article, Research Support, N.I.H., Extramural, Review)

Chemical References

• Antifibrinolytic Agents
• Tranexamic Acid

Topics

• Antifibrinolytic Agents (therapeutic use)
• Blood Coagulation Disorders (drug therapy)
• Hemostasis
• Humans
• Perioperative Care (methods)
• Tranexamic Acid (therapeutic use)
• Wounds and Injuries (therapy)