TXA – an update

PHEMCAST

Read more about the Cochrane injuries group: https://injuries.cochrane.org/about-us-0

Have a listen to the earlier TXA podcast here: https://phemcast.co.uk/2018/01/18/episode-26-tranexamic-acid/

Do you want to revise your clotting pathways and the mechanism of action of TXA?!

Here are some links to the excellent Life in the Fast Lane:

https://partone.litfl.com/clotting.html

https://partone.litfl.com/unclotting.html

Acute Coagulopathy of Trauma

Tranexamic Acid

The Resus Room podcast which discusses Tim and colleagues paper on gender differences in TXA administration is available here: https://www.theresusroom.co.uk/courses/papers-of-june-2022/

Want to read more about Crash 4? https://crash4.lshtm.ac.uk

References

Crash 2: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(10)60835-5/fulltext

Crash 3: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(19)32233-0/fulltext

WOMAN: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(17)30638-4/fulltext

Use of tranexamic acid in major trauma: a sex-disaggragated analysis of the Clinical Randomisation of an Antifibrinolytic in Significant Haemorrhage (CRASH-2 and CRASH-3) trials and UK trauma registry (Trauma and Audit Research Network) data. Tim Nutbeam. Br J Anaesth. 2022

OKAMOTO, SHOSUKE, and UTAKO OKAMOTO. “Amino-methyl-cyclohexane-carboxylic acid: AMCHA a new potent inhibitor of the fibrinolysis.” The Keio Journal of Medicine 11.3 (1962): 105-115. https://www.jstage.jst.go.jp/article/kjm1952/11/3/11_3_105/_article/-char/ja/

Grassin-Delyle S et al. Pharmacokinetics of intramuscular tranexamic acid in bleeding trauma patients: a clinical trial. British Journal of Anaesthesia, Volume 126, Issue 1,2021 https://www.sciencedirect.com/science/article/pii/S0007091220306826

Henry DA, Carless PA, Moxey AJ, O’Connell D, Stokes BJ, Fergusson DA, Ker K. Anti‐fibrinolytic use for minimising perioperative allogeneic blood transfusion. Cochrane Database of Systematic Reviews 2011, Issue 3. Art. No.: CD001886. DOI: 10.1002/14651858.CD001886.pub4. https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD001886.pub4/full

Ageron, FX., Coats, T.J., Darioli, V. et al. Validation of the BATT score for prehospital risk stratification of traumatic haemorrhagic death: usefulness for tranexamic acid treatment criteria. Scand J Trauma Resusc Emerg Med 29, 6 (2021).

Guyette FX et al. Tranexamic acid during prehospital transport in patients at risk for hemorrhage after injury: A double-blind, placebo-controlled, randomized clinical trial. JAMA Surg 2020. PMID: 33016996

Marcucci M et al. Rationale and design of the PeriOperative ISchemic Evaluation-3 (POISE-3): a randomized controlled trial evaluating tranexamic acid and a strategy to minimize hypotension in noncardiac surgery. Trials. 2022 Jan 31;23(1):101. doi: 10.1186/s13063-021-05992-1. PMID: 35101083; PMCID: PMC8805242.