Topical use of tranexamic acid for the management of post-procedural rectal bleeding

Altawil, Zaid; Gendron, Bryan J.; Schechter‐Perkins, Elissa M.

doi:10.1016/j.ajem.2018.09.037

Cited by 6 publications

(1 citation statement)

References 15 publications

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“…There is a growing body of literature on TXA and its effects following both systemic and topical administration. [64][65][66][67] Large trials evaluating TXA are ongoing, and identification of patients most likely to benefit from TXA remains elusive. The current evidence suggests that TXA is a useful adjunct in severe hemorrhage, irrespective of the underlying cause (Table 4).…”

Section: Discussionmentioning

confidence: 99%

The Role of Tranexamic Acid in the Management of an Acutely Hemorrhaging Patient

et al. 2020

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Background: Acute hemorrhage, both traumatic and nontraumatic, leads to significant morbidity and mortality, both in the United States and globally. Traditional treatment of acute hemorrhage is focused on hemostasis and blood product replacement. Tranexamic acid is an antifibrinolytic agent that may reduce acute hemorrhage through inhibition of plasminogen. Newer research suggests that coagulopathy, specifically fibrinolysis, may contribute significantly to the pathology of acute hemorrhage. Methods: We searched the PubMed database for relevant articles from 2000 to 2018 for the terms “tranexamic acid,” “TXA,” “antifibrinolytic,” “hyperfibrinolysis,” and “coagulopathy.” Our search was limited to studies published in the English language. Results: A total of 53 studies were included in this review. These articles suggest a potential role for tranexamic acid in the management of acute intracranial hemorrhage, epistaxis, hematuria, postpartum hemorrhage, gastrointestinal hemorrhage, and trauma-related hemorrhage. A theoretical risk of thrombotic events following tranexamic acid use exists, though large clinical trials suggest this risk remains exceedingly small. Conclusions: Recent studies suggest a mortality benefit with tranexamic acid following acute hemorrhage. First responders such as emergency medical technicians and emergency department clinicians should consider tranexamic acid as an adjunct therapy in the management of acute, severe traumatic and nontraumatic hemorrhage.

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Section: Discussionmentioning

confidence: 99%