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Does tranexamic acid stop haemoptysis?

Christian Arvei Moen1, Amy Burrell, Joel Dunning

  • 1Department of Clinical Science, University of Bergen, Bergen, Norway.

Interactive Cardiovascular and Thoracic Surgery
|August 23, 2013
PubMed
Summary

Tranexamic acid (TA) may reduce bleeding duration and volume in patients with haemoptysis. While not improving remission rates, TA shows a low risk of short-term thromboembolic complications, though further research is needed.

Keywords:
Antifibrinolytic agentsBleedingHaemoptysisHaemostasisReviewTranexamic acid

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Area of Science:

  • Thoracic Surgery
  • Pulmonology
  • Critical Care Medicine

Background:

  • Haemoptysis, or coughing up blood, is a serious condition requiring effective treatment.
  • Tranexamic acid (TA) is a potential therapeutic agent for managing bleeding episodes.

Purpose of the Study:

  • To evaluate the efficacy and safety of tranexamic acid (TA) in treating haemoptysis.
  • To synthesize the best available evidence on TA for haemoptysis management.

Main Methods:

  • A systematic review and meta-analysis of randomized controlled trials (RCTs) and other relevant studies.
  • Inclusion of 13 high-quality papers, including RCTs, cohort studies, case-series, and case reports.
  • Assessment of outcomes such as bleeding time, bleeding volume, and thromboembolic complications.

Main Results:

  • Meta-analysis showed no significant difference in bleeding remission within 1 week between TA and placebo.
  • Overall bleeding time was significantly shorter in the TA group.
  • One RCT demonstrated reduced bleeding duration and volume with TA; the other RCT found no significant difference.
  • Low incidence of short-term thromboembolic complications, though two case reports noted pulmonary embolism.

Conclusions:

  • Limited research exists on TA for haemoptysis, with varied study designs and parameters.
  • Current evidence suggests TA may reduce bleeding duration and volume in haemoptysis patients.
  • TA appears to have a low risk of short-term thromboembolic complications, but strong recommendations are difficult due to study heterogeneity.