Topic of the Month:
Tranexemic Acid (TXA)
See What Austraila Air Ambulance is doing with TXA (video link)
The Crash 2 clinical trial was a study conducted to evaluate the effects of TXA in bleeding trauma patients.
click here to review the trial.
What is TXA? TXA is a medication that has been around for a long time that is just now gaining popularity in trauma. It is a anti-fibrinyloytic. It works by inhibiting fibrinolysis by displacing plasminogen from fibrin.
When is it indicated? TXA is indicated for bleeding trauma patients. Systolic BP 75 or less. and given within 3 hours of injury.
When is it contraindicated? Isolated head injury, injury >3 hours, more urgent critical intervention needed (dont delay delay to give TXA)
Is it effective? Please review the studies below to see for yourself! (Spoiler Alert! - if TXA is used properly it saves lives!)
Military Application of Tranexamic Acid in Trauma Emergency Resuscitation (MATTERs) Study. Click here to learn more.
Here is the conclusion of the study:
The use of TXA with blood component-based resuscitation following combat injury results in improved measures of coagulopathy and survival, a benefit that is most prominent in patients requiring massive transfusion. Treatment with TXA should be implemented into clinical practice as part of a resuscitation strategy following severe wartime injury and hemorrhage
(http://www.ncbi.nlm.nih.gov/pubmed/22006852)
Here is the conclusion of the Crash 2 study:
Early administration of TXA safely reduced the risk of death in bleeding trauma patients and is highly cost-effective. Treatment beyond 3 hours of injury is unlikely to be effective. Future work [the Clinical Randomisation of an Antifibrinolytic in Significant Head injury-3 (CRASH-3) trial] will evaluate the effectiveness and safety of TXA in the treatments of isolated traumatic brain injury.