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Clinical use of tranexamic acid: evidences and controversies
Tranexamic acid (TXA) significantly reduces blood loss in a wide range of surgical procedures and improves survival rates in obstetric and trauma patients with severe bleeding. Although it mainly acts as a fibrinolysis inhibitor, it also has an anti-inflammatory effect, and may help attenuate the sy...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Elsevier
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9660007/ https://www.ncbi.nlm.nih.gov/pubmed/34626756 http://dx.doi.org/10.1016/j.bjane.2021.08.022 |
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author | Colomina, Maria J. Contreras, Laura Guilabert, Patricia Koo, Maylin M..ndez, Esther Sabate, Antoni |
author_facet | Colomina, Maria J. Contreras, Laura Guilabert, Patricia Koo, Maylin M..ndez, Esther Sabate, Antoni |
author_sort | Colomina, Maria J. |
collection | PubMed |
description | Tranexamic acid (TXA) significantly reduces blood loss in a wide range of surgical procedures and improves survival rates in obstetric and trauma patients with severe bleeding. Although it mainly acts as a fibrinolysis inhibitor, it also has an anti-inflammatory effect, and may help attenuate the systemic inflammatory response syndrome found in some cardiac surgery patients. However, the administration of high doses of TXA has been associated with seizures and other adverse effects that increase the cost of care, and the administration of TXA to reduce perioperative bleeding needs to be standardized. Tranexamic acid is generally well tolerated, and most adverse reactions are considered mild or moderate. Severe events are rare in clinical trials, and literature reviews have shown tranexamic acid to be safe in several different surgical procedures. However, after many years of experience with TXA in various fields, such as orthopedic surgery, clinicians are now querying whether the dosage, route and interval of administration currently used and the methods used to control and analyze the antifibrinolytic mechanism of TXA are really optimal. These issues need to be evaluated and reviewed using the latest evidence to improve the safety and effectiveness of TXA in treating intracranial hemorrhage and bleeding in procedures such as liver transplantation, and cardiac, trauma and obstetric surgery. |
format | Online Article Text |
id | pubmed-9660007 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Elsevier |
record_format | MEDLINE/PubMed |
spelling | pubmed-96600072022-11-15 Clinical use of tranexamic acid: evidences and controversies Colomina, Maria J. Contreras, Laura Guilabert, Patricia Koo, Maylin M..ndez, Esther Sabate, Antoni Braz J Anesthesiol Narrative Review Tranexamic acid (TXA) significantly reduces blood loss in a wide range of surgical procedures and improves survival rates in obstetric and trauma patients with severe bleeding. Although it mainly acts as a fibrinolysis inhibitor, it also has an anti-inflammatory effect, and may help attenuate the systemic inflammatory response syndrome found in some cardiac surgery patients. However, the administration of high doses of TXA has been associated with seizures and other adverse effects that increase the cost of care, and the administration of TXA to reduce perioperative bleeding needs to be standardized. Tranexamic acid is generally well tolerated, and most adverse reactions are considered mild or moderate. Severe events are rare in clinical trials, and literature reviews have shown tranexamic acid to be safe in several different surgical procedures. However, after many years of experience with TXA in various fields, such as orthopedic surgery, clinicians are now querying whether the dosage, route and interval of administration currently used and the methods used to control and analyze the antifibrinolytic mechanism of TXA are really optimal. These issues need to be evaluated and reviewed using the latest evidence to improve the safety and effectiveness of TXA in treating intracranial hemorrhage and bleeding in procedures such as liver transplantation, and cardiac, trauma and obstetric surgery. Elsevier 2021-10-07 /pmc/articles/PMC9660007/ /pubmed/34626756 http://dx.doi.org/10.1016/j.bjane.2021.08.022 Text en © 2021 Published by Elsevier Editora Ltda. on behalf of Sociedade Brasileira de Anestesiologia. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). |
spellingShingle | Narrative Review Colomina, Maria J. Contreras, Laura Guilabert, Patricia Koo, Maylin M..ndez, Esther Sabate, Antoni Clinical use of tranexamic acid: evidences and controversies |
title | Clinical use of tranexamic acid: evidences and controversies |
title_full | Clinical use of tranexamic acid: evidences and controversies |
title_fullStr | Clinical use of tranexamic acid: evidences and controversies |
title_full_unstemmed | Clinical use of tranexamic acid: evidences and controversies |
title_short | Clinical use of tranexamic acid: evidences and controversies |
title_sort | clinical use of tranexamic acid: evidences and controversies |
topic | Narrative Review |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9660007/ https://www.ncbi.nlm.nih.gov/pubmed/34626756 http://dx.doi.org/10.1016/j.bjane.2021.08.022 |
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