The Use of Tranexamic Acid in Trauma

Thota, Bhavana; Marinica, Alexander L.; Oh, Matthew W.; Cripps, Michael W.; Moon, Tiffany S.

doi:10.1007/s40140-021-00509-7

Cited by 3 publications

(4 citation statements)

References 46 publications

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“…Patients receiving TXA also required less pRBCs [12]. Subsequently, the MATTERs and MATTERs II studies further supported these findings in a military setting [11 ▪ ]. The CRASH-3 trial reaffirmed findings for adult patients with acute traumatic brain injury to support giving TXA within 3 h of injury to reduce head injury-related death within the first 24 h. These findings were relevant in mild to moderate (but not severe) head injury without significant adverse effects or complications [13].…”

Section: Red Blood Cell Alternativesmentioning

confidence: 99%

“…Tranexamic acid (TXA) is a synthetic form of lysine, which competitively inhibits activation of plasminogen to plasmin to stabilize previously formed clots [11 ▪ ]. This product is generally accepted by most Jehovah's witnesses as it is synthetic [7].…”

Section: Red Blood Cell Alternativesmentioning

confidence: 99%

“…The CRASH-3 trial reaffirmed findings for adult patients with acute traumatic brain injury to support giving TXA within 3 h of injury to reduce head injury-related death within the first 24 h. These findings were relevant in mild to moderate (but not severe) head injury without significant adverse effects or complications [13]. Of note, there are further smaller cohort studies that did not find a reduction in mortality and a 3-fold increased risk of venous thromboembolic events in those receiving TXA [11 ▪ ]. However, TXA still remains a well established therapy in trauma.…”

Section: Red Blood Cell Alternativesmentioning

confidence: 99%

“…This product is generally accepted by most Jehovah's witnesses as it is synthetic [7]. In trauma, 1 g of TXA is recommended to be used empirically (within the first 3 h of injury) or therapeutically (for a prolonged LY-30 on VHA) [11 ▪ ]. CRASH-2 is a landmark randomized control trial that prompted routine TXA utilization for adult trauma patients.…”

Section: Red Blood Cell Alternativesmentioning

confidence: 99%

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Alternative blood products in trauma

Jan

Mohapatra

Moon

2022

Current Opinion in Anaesthesiology

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Purpose of reviewHemorrhage and trauma-induced coagulopathy cause significant morbidity and mortality in trauma patients. Although blood products are the cornerstone of resuscitation, these resources are scarce, necessitating alternatives. This review examines the use of alternative blood products in trauma as well as the literature supporting their use.Recent findingsThere is no single true blood product alternative. In recent years, there has been great progress in understanding trauma-induced pathophysiology and blood component alternatives. Products such as tranexamic acid and prothrombin complex concentrate have become well established and are frequently utilized in trauma centers, and many more alternatives are still undergoing further research and development.SummaryStabilization of hemorrhage and resuscitation is priority in trauma-induced coagulopathy treatment. Alternative products such as tranexamic acid, recombinant factors, prothrombic complex concentrate, fibrinogen concentrates, and desmopressin may also be considered based on the clinical context. Viscoelastic hemostatic assays such as rotational thromboelastometry and thromboelastography can help guide these efforts. Following initial stabilization, additional interventions such as iron supplementation, erythropoietin stimulating agents, and vitamin D may help with chronic sequela.

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Section: Red Blood Cell Alternativesmentioning

confidence: 99%

Section: Red Blood Cell Alternativesmentioning

confidence: 99%

Section: Red Blood Cell Alternativesmentioning

confidence: 99%

Section: Red Blood Cell Alternativesmentioning

confidence: 99%

See 2 more Smart Citations

Alternative blood products in trauma

Jan

Mohapatra

Moon

2022

Current Opinion in Anaesthesiology

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Updates on Hemostatic Strategies in Acute Trauma: Use of Whole Blood, Tranexamic Acid and Fibrinogen Replacement

Campbell,

Jefferies,

Stephens

et al. 2024

Curr Anesthesiol Rep

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Consensus recommendations for acute trauma care & outcomes in LMICs from the transdisciplinary research, advocacy & implementation network for trauma in India

Roy,

Khajanchi,

Alty

et al. 2024

IJMR

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Background & objectives Injuries profoundly impact global health, with substantial deaths and disabilities, especially in low- and middle-income countries (LMICs). This paper presents strategic consensus from the Transdisciplinary Research, Advocacy, and Implementation Network for Trauma in India (TRAIN Trauma India) symposium, advocating for enhanced, system-level trauma care to address this challenge. Methods Five working groups conducted separate literature reviews on pre-hospital trauma care, in-hospital trauma resuscitation and training, trauma systems, trauma registries, and India’s Towards Improving Trauma Care Outcomes (TITCO) registry. Using a Delphi approach, the TRAIN Trauma India Symposium generated consensus statements and recommendations for interventions to streamline trauma care and reduce preventable trauma mortality in India and LMICs. Experts prioritized interventions based on cost and difficulty. Results An expert panel agreed on four pre-hospital consensus statements, eight hospital resuscitation consensus statements, six system-level consensus statements, and six trauma registry consensus statements. The expert panel recommended six pre-hospital interventions, four hospital resuscitation interventions, nine system-level interventions, and seven trauma registry interventions applicable to the Indian context. Of these, 14 interventions were ranked as low cost/low difficulty, five high cost/low difficulty, five low cost/high difficulty, and three high cost/high difficulty. Interpretation & conclusions This consensus underscores the urgent need for integrated and efficient trauma systems to reduce preventable mortality, emphasizing the importance of comprehensive care that includes community engagement and robust pre-hospital and acute hospital trauma care pathways. It highlights the critical role of inclusive, system-wide approaches, from enhancing pre-hospital care and in-hospital resuscitation to implementing effective trauma registries to improve outcomes and streamline care across contexts.

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The Use of Tranexamic Acid in Trauma

Cited by 3 publications

References 46 publications

Alternative blood products in trauma

Alternative blood products in trauma

Updates on Hemostatic Strategies in Acute Trauma: Use of Whole Blood, Tranexamic Acid and Fibrinogen Replacement

Consensus recommendations for acute trauma care & outcomes in LMICs from the transdisciplinary research, advocacy & implementation network for trauma in India

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