Tranexamic acid in epistaxis: a systematic review

Kamhieh, Yasmine; Fox, Hannah

doi:10.1111/coa.12645

Cited by 35 publications

(33 citation statements)

References 29 publications

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“…The World Health Organization lists TXA as an essential medication . It is an antifibrinolytic drug and a synthetic derivative of the amino acid lysine that reduces plasmin concentration by blocking the lysine‐binding sites of plasminogen, which in turn inhibits the binding of plasminogen to fibrin and then conversion of plasminogen to plasmin .…”

Section: Discussionmentioning

confidence: 99%

Topical Tranexamic Acid Compared With Anterior Nasal Packing for Treatment of Epistaxis in Patients Taking Antiplatelet Drugs: Randomized Controlled Trial

Zahed

Jazayeri

Naderi

et al. 2017

Academic Emergency Medicine

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Section: Discussionmentioning

confidence: 99%

Topical Tranexamic Acid Compared With Anterior Nasal Packing for Treatment of Epistaxis in Patients Taking Antiplatelet Drugs: Randomized Controlled Trial

Zahed

Jazayeri

Naderi

et al. 2017

Academic Emergency Medicine

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“…[46][47][48][49] In RCTs Reuben et al reported that tranexamic acid is effective to reduce nasal packing for the management of epistaxis. [50][51][52] Tranexamic acid is cheap and convenient as compared to nasal packing and even easy to apply via intravenous or topical forms as per need in emergency situations.…”

Section: Efficacy Of Txa In Ent Epistaxismentioning

confidence: 99%

Role of tranexamic acid to reduce blood loss and transfusion of allogeneic blood in the field of surgery

Shrestha

Tao

2020

Asian J Med Sci

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Tranexamic acid is widely used as an antifibrinolytic drug to reduce blood loss intraoperative and postoperative time periods as well as to reduce transfusion of allogeneic blood. After releasing in the market, multidisciplinary surgeries have wide use of tranexamic acid due to its antifibrinolytic effect to reduce bleeding and transfusion of blood. In literature, there were mentioned a few adverse effects like thromboembolism, seizure, anaphylactic reaction, etc which are still unsolved questions to date. The aim of this review to minimize the blood loss from acute bleeding in different situations by updating the doses used in a different clinical scenario,since the release of tranexamic acid. It also gives an idea about appropriate doses to reduce blood loss, need for blood transfusion, minimize adverse effects and to understand the wide scope of application of TXA to date.

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“…There are nine studies relating to tranexamic acid use in epistaxis, three literature reviews (22)(23)(24) , one systemic review (25) , one retrospective review (21) and four randomised control trials (RCTs) (26)(27)(28)(29) . No study investigated the use of tranexamic acid in those individuals on antithrombotic medication.…”

Section: Basic Coagulation Screenmentioning

confidence: 99%

“…Two other RCTs investigated the use of tranexamic acid gel and tranexamic acid orally compared to placebo, neither showed any statistically significant differences (28,29) . A systemic review by Kamhieh et al showed no benefit to oral tranexamic acid and no clear benefit to topical tranexamic acid (24) . This review occurred prior to the second RCT demonstrating significant benefit with topical tranexamic acid.…”

Section: Basic Coagulation Screenmentioning

confidence: 99%

A systematic review of anti-thrombotic therapy in epistaxis

Musgrave

Powell

2016

Rhin

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There is limited guidance available to clinicians regarding the management of antithrombotic therapy during epistaxis, whilst there has been an increase in the use of anticoagulation and antiplatelet therapy. In addition, the introduction of direct oral anticoagulants (DOACs), such as dabigatran and rivaroxaban, over the last decade has significantly increased the complexity of managing the anticoagulated epistaxis patient. We undertook a systemic literature review investigating potential management strategies for each class of anti-thrombotic therapy during epistaxis. A PubMED and Cochrane Library search was performed on 10/03/16 using, but not limited to, the search terms epistaxis, nosebleed, nose bleeding, nasal haemorrhage, nasal bleeding AND each of the following search terms: antithrombotic, anticoagulant, antiplatelet, aspirin, clopidogrel, warfarin, dabigatran, rivaroxaban, apixaban and tranexamic acid. This yielded 3815 results, of which 29 were considered relevant. Other sources such as national and international guidelines related to the management of anti-thrombotics were also utilised. We present the findings related to the management of each class of anti-thrombotic therapy during epistaxis. Overall we found a lack of evidence regarding this topic and further high quality research is needed. This is an area growing in complexity and the support of colleagues in Haematology and Cardiology is increasingly important.

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Tranexamic acid in epistaxis: a systematic review

Cited by 35 publications

References 29 publications

Topical Tranexamic Acid Compared With Anterior Nasal Packing for Treatment of Epistaxis in Patients Taking Antiplatelet Drugs: Randomized Controlled Trial

Topical Tranexamic Acid Compared With Anterior Nasal Packing for Treatment of Epistaxis in Patients Taking Antiplatelet Drugs: Randomized Controlled Trial

Role of tranexamic acid to reduce blood loss and transfusion of allogeneic blood in the field of surgery

A systematic review of anti-thrombotic therapy in epistaxis

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