Skip to main content

Tranexamic Acid in Trauma Patients

  • Chapter
  • First Online:
Reducing Mortality in Critically Ill Patients

Abstract

Traumatic injuries are a considerable public health burden with significant personal and social costs. Hemorrhage is responsible for a third of in-hospital trauma deaths and contributes to deaths due to multiorgan failure [1].

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

eBook
USD 16.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 109.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 159.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Similar content being viewed by others

References

  1. Sauaia A, Moore FA, Moore EE, et al. Epidemiology of trauma deaths: a reassessment. J Trauma. 1995;38:185–93.

    Article  CAS  Google Scholar 

  2. Brohi K, Cohen MJ, Ganter MT, et al. Acute coagulopathy of trauma: hypoperfusion induces systemic anticoagulation and hyperfibrinolysis. J Trauma. 2008;64:1211–7.

    PubMed  Google Scholar 

  3. Henry DA, Carless PA, Moxey AJ, O’Connel D, Stokes BJ, Fergusson DA, Ker K. Anti-fibrinolytic use for minimising perioperative allogeneic blood transfusion. Cochrane Database Syst Rev. 2011;19(1):CD001886.

    Google Scholar 

  4. The CRASH-2 Collaborators. Effects of TXA on death, vascular occlusive events, and blood transfusion in trauma patients with significant hemorrhage (CRASH-2): a randomised, placebo-controlled trial. Lancet. 2010;376:23–32.

    Article  Google Scholar 

  5. The CRASH-2 Collaborators. The importance of early treatment with TXA in bleeding trauma patients: an exploratory analysis of the CRASH-2 randomised controlled trial. Lancet. 2011;377:1096–101.

    Article  Google Scholar 

  6. Ker K, Prieto-Merino D, Roberts I. Systematic review, meta-analysis and meta regression of the effect of tranexamic acid on surgical blood loss. Br J Surg. 2013;100:1271–9.

    Article  CAS  Google Scholar 

  7. Perel P, Ker K, Morales Uribe CH, Roberts I. Tranexamic acid for reducing mortality in emergency and urgent surgery. Cochrane Database Syst Rev. 2013;31(1):CD010245.

    Google Scholar 

  8. Ker K, Edwards P, Perel P, Shakur H, Roberts I. Effect of tranexamic acid on surgical bleeding: systematic review and cumulative meta-analysis. BMJ. 2012;344:e30542.

    Article  Google Scholar 

  9. Roberts I, Shakur H, Ker K, Coats T, CRASH-2 Trial Collaborators. Antifibrinolytic drugs for acute traumatic injury. Cochrane Database Syst Rev. 2012;1:CD004896.

    Google Scholar 

  10. Roberts I, Perel P, Prieto-Merino D, Shakur H, Coats T, Hunt BJ, Lecky F, Brohi K, Willwt K. Effect of tranexamic acid on mortality in patients with traumatic bleeding: prespecified analysis of data from randomised controlled trial. BMJ. 2012;345:e5839.

    Article  Google Scholar 

  11. Godier A, Roberts I, Hunt BJ. Tranexamic acid: less bleeding and less thrombosis? Crit Care. 2012;16(3):135.

    Article  Google Scholar 

  12. The CRASH-3 Trial Collaborators. Effects of tranexamic acid on death, disability, vascular occlusive events and other morbidities in patients with acute traumatic brain injury (CRASH-3): a randomized, placebo-controlled trial. Lancet. 2019;394(10210):1713–23.

    Article  Google Scholar 

  13. Stief TW. Drug-induced thrombin generation: the breakthrough. Hemost Lab. 2010;3:3–6.

    Google Scholar 

  14. Dirkmann D, Gorlinger K, Gisbertz C, et al. Factor XIII and TXA but not recombinant factor VIIa attenuate tissue plasminogen activator-induced hyperfibrinolysis in human whole blood. Anesth Analg. 2012;114(6):1182–8.

    Article  CAS  Google Scholar 

  15. Sawamura A, Hayakawa M, Gando S, et al. Disseminated intravascular coagulation with a fibrinolytic phenotype at an early phase of trauma predicts mortality. Thromb Res. 2009;1214:608–13.

    Article  Google Scholar 

  16. Eriksson O, Kjellman H, Pilbrant A, Schannong M. Pharmacokinetics of TXA after intravenous administration to normal volunteers. Eur J Clin Pharmacol. 1974;7:375–80.

    Article  CAS  Google Scholar 

  17. Faraoni D, Goobie SM. The efficacy of Antifibrinolytic drugs in children undergoing noncardiac surgery: a systematic review of the literature. Anesth Analg. 2014;118:628–36.

    Article  CAS  Google Scholar 

  18. Morrison JJ, Dubose JJ, Rasmussen TE, Midwinter MJ. Military application of tranexamic acid in trauma emergency resuscitation (MATTERs) study. Arch Surg. 2012;147(2):113–9.

    Article  CAS  Google Scholar 

  19. Spahn DR, Bouillon B, Cerny V, Coats TJ, Duranteau J, Fernández-Mondéjar E, Filipescu D, Hunt BJ, Komadina R, Nardi G, Neugebauer E, Ozier Y, Riddez L, Schultz A, Vincent J-L, Rossaint R. Management of bleeding and coagulopathy following major trauma: an updated European Guideline. Spahn et al. Critical Care. 2013;17:R76. http://ccforum.com/content/17/2/R76

    Article  Google Scholar 

  20. National Institute for Health and Clinical Excellence. Major trauma: assessment and initial management NICE guideline [NG39]. Published date: 17 February 2016.

    Google Scholar 

  21. I Roberts, T Kawahara. Proposal for the inclusion of TXA (antifibrinolytic – lysine analogue) in the WHO model list of essential medicines. In: 18th expert committee on the selection and use of essential medicines. Published on 2 June 2010.

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Annalisa Volpi .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2021 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Volpi, A., Grossi, S., Mazzani, R. (2021). Tranexamic Acid in Trauma Patients. In: Landoni, G., Baiardo Redaelli, M., Sartini, C., Zangrillo, A., Bellomo, R. (eds) Reducing Mortality in Critically Ill Patients. Springer, Cham. https://doi.org/10.1007/978-3-030-71917-3_14

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-71917-3_14

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-71916-6

  • Online ISBN: 978-3-030-71917-3

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics