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Effects of tranexamic acid on coagulofibrinolytic markers during the early stage of severe trauma: A propensity score–matched analysis

Tranexamic acid (TXA) reduces the risk of bleeding trauma death without altering the need for blood transfusion. We examined the effects of TXA on coagulation and fibrinolysis dynamics and the volume of transfusion during the early stage of trauma. This subanalysis of a prospective multicenter study...

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Autores principales: Gando, Satoshi, Shiraishi, Atsushi, Wada, Takeshi, Yamakawa, Kazuma, Fujishima, Seitaro, Saitoh, Daizoh, Kushimoto, Shigeki, Ogura, Hiroshi, Abe, Toshikazu, Mayumi, Toshihiko, Sasaki, Junichi, Kotani, Joji, Takeyama, Naoshi, Tsuruta, Ryosuke, Takuma, Kiyotsugu, Shiraishi, Shin-ichiro, Shiino, Yasukazu, Nakada, Taka-aki, Okamoto, Kohji, Sakamoto, Yuichiro, Hagiwara, Akiyoshi, Fujimi, Satoshi, Umemura, Yutaka, Otomo, Yasuhiro
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Lippincott Williams & Wilkins 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9371565/
https://www.ncbi.nlm.nih.gov/pubmed/35960088
http://dx.doi.org/10.1097/MD.0000000000029711
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author Gando, Satoshi
Shiraishi, Atsushi
Wada, Takeshi
Yamakawa, Kazuma
Fujishima, Seitaro
Saitoh, Daizoh
Kushimoto, Shigeki
Ogura, Hiroshi
Abe, Toshikazu
Mayumi, Toshihiko
Sasaki, Junichi
Kotani, Joji
Takeyama, Naoshi
Tsuruta, Ryosuke
Takuma, Kiyotsugu
Shiraishi, Shin-ichiro
Shiino, Yasukazu
Nakada, Taka-aki
Okamoto, Kohji
Sakamoto, Yuichiro
Hagiwara, Akiyoshi
Fujimi, Satoshi
Umemura, Yutaka
Otomo, Yasuhiro
author_facet Gando, Satoshi
Shiraishi, Atsushi
Wada, Takeshi
Yamakawa, Kazuma
Fujishima, Seitaro
Saitoh, Daizoh
Kushimoto, Shigeki
Ogura, Hiroshi
Abe, Toshikazu
Mayumi, Toshihiko
Sasaki, Junichi
Kotani, Joji
Takeyama, Naoshi
Tsuruta, Ryosuke
Takuma, Kiyotsugu
Shiraishi, Shin-ichiro
Shiino, Yasukazu
Nakada, Taka-aki
Okamoto, Kohji
Sakamoto, Yuichiro
Hagiwara, Akiyoshi
Fujimi, Satoshi
Umemura, Yutaka
Otomo, Yasuhiro
author_sort Gando, Satoshi
collection PubMed
description Tranexamic acid (TXA) reduces the risk of bleeding trauma death without altering the need for blood transfusion. We examined the effects of TXA on coagulation and fibrinolysis dynamics and the volume of transfusion during the early stage of trauma. This subanalysis of a prospective multicenter study of severe trauma included 276 patients divided into propensity score–matched groups with and without TXA administration. The effects of TXA on coagulation and fibrinolysis markers immediately at (time point 0) and 3 hours after (time point 3) arrival at the emergency department were investigated. The transfusion volume was determined at 24 hours after admission. TXA was administered to the patients within 3 hours (median, 64 minutes) after injury. Significant reductions in fibrin/fibrinogen degradation products and D-dimer levels from time points 0 to 3 in the TXA group compared with the non-TXA group were confirmed, with no marked differences noted in the 24-hour transfusion volumes between the 2 groups. Continuously increased levels of soluble fibrin, a marker of thrombin generation, from time points 0 to 3 and high levels of plasminogen activator inhibitor-1, a marker of inhibition of fibrinolysis, at time point 3 were observed in both groups. TXA inhibited fibrin(ogen)olysis during the early stage of severe trauma, although this was not associated with a reduction in the transfusion volume. Other confounders affecting the dynamics of fibrinolysis and transfusion requirement need to be clarified.
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spelling pubmed-93715652022-08-16 Effects of tranexamic acid on coagulofibrinolytic markers during the early stage of severe trauma: A propensity score–matched analysis Gando, Satoshi Shiraishi, Atsushi Wada, Takeshi Yamakawa, Kazuma Fujishima, Seitaro Saitoh, Daizoh Kushimoto, Shigeki Ogura, Hiroshi Abe, Toshikazu Mayumi, Toshihiko Sasaki, Junichi Kotani, Joji Takeyama, Naoshi Tsuruta, Ryosuke Takuma, Kiyotsugu Shiraishi, Shin-ichiro Shiino, Yasukazu Nakada, Taka-aki Okamoto, Kohji Sakamoto, Yuichiro Hagiwara, Akiyoshi Fujimi, Satoshi Umemura, Yutaka Otomo, Yasuhiro Medicine (Baltimore) Research Article Tranexamic acid (TXA) reduces the risk of bleeding trauma death without altering the need for blood transfusion. We examined the effects of TXA on coagulation and fibrinolysis dynamics and the volume of transfusion during the early stage of trauma. This subanalysis of a prospective multicenter study of severe trauma included 276 patients divided into propensity score–matched groups with and without TXA administration. The effects of TXA on coagulation and fibrinolysis markers immediately at (time point 0) and 3 hours after (time point 3) arrival at the emergency department were investigated. The transfusion volume was determined at 24 hours after admission. TXA was administered to the patients within 3 hours (median, 64 minutes) after injury. Significant reductions in fibrin/fibrinogen degradation products and D-dimer levels from time points 0 to 3 in the TXA group compared with the non-TXA group were confirmed, with no marked differences noted in the 24-hour transfusion volumes between the 2 groups. Continuously increased levels of soluble fibrin, a marker of thrombin generation, from time points 0 to 3 and high levels of plasminogen activator inhibitor-1, a marker of inhibition of fibrinolysis, at time point 3 were observed in both groups. TXA inhibited fibrin(ogen)olysis during the early stage of severe trauma, although this was not associated with a reduction in the transfusion volume. Other confounders affecting the dynamics of fibrinolysis and transfusion requirement need to be clarified. Lippincott Williams & Wilkins 2022-08-12 /pmc/articles/PMC9371565/ /pubmed/35960088 http://dx.doi.org/10.1097/MD.0000000000029711 Text en Copyright © 2022 the Author(s). Published by Wolters Kluwer Health, Inc. https://creativecommons.org/licenses/by-nc/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial License 4.0 (CCBY-NC) (https://creativecommons.org/licenses/by-nc/4.0/) , where it is permissible to download, share, remix, transform, and buildup the work provided it is properly cited. The work cannot be used commercially without permission from the journal.
spellingShingle Research Article
Gando, Satoshi
Shiraishi, Atsushi
Wada, Takeshi
Yamakawa, Kazuma
Fujishima, Seitaro
Saitoh, Daizoh
Kushimoto, Shigeki
Ogura, Hiroshi
Abe, Toshikazu
Mayumi, Toshihiko
Sasaki, Junichi
Kotani, Joji
Takeyama, Naoshi
Tsuruta, Ryosuke
Takuma, Kiyotsugu
Shiraishi, Shin-ichiro
Shiino, Yasukazu
Nakada, Taka-aki
Okamoto, Kohji
Sakamoto, Yuichiro
Hagiwara, Akiyoshi
Fujimi, Satoshi
Umemura, Yutaka
Otomo, Yasuhiro
Effects of tranexamic acid on coagulofibrinolytic markers during the early stage of severe trauma: A propensity score–matched analysis
title Effects of tranexamic acid on coagulofibrinolytic markers during the early stage of severe trauma: A propensity score–matched analysis
title_full Effects of tranexamic acid on coagulofibrinolytic markers during the early stage of severe trauma: A propensity score–matched analysis
title_fullStr Effects of tranexamic acid on coagulofibrinolytic markers during the early stage of severe trauma: A propensity score–matched analysis
title_full_unstemmed Effects of tranexamic acid on coagulofibrinolytic markers during the early stage of severe trauma: A propensity score–matched analysis
title_short Effects of tranexamic acid on coagulofibrinolytic markers during the early stage of severe trauma: A propensity score–matched analysis
title_sort effects of tranexamic acid on coagulofibrinolytic markers during the early stage of severe trauma: a propensity score–matched analysis
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9371565/
https://www.ncbi.nlm.nih.gov/pubmed/35960088
http://dx.doi.org/10.1097/MD.0000000000029711
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