Comparing Adrenaline with Tranexamic Acid to Control Acute Endobronchial Bleeding: A Randomized Controlled Trial

Area of Science:

• Pulmonology
• Endoscopy
• Pharmacology

Background:

• Hemoptysis, or coughing up blood, can stem from pulmonary conditions or bronchoscopy procedures.
• This study investigates treatments for hemoptysis unresponsive to initial interventions.

Purpose of the Study:

• To compare the effectiveness of endobronchial adrenaline versus tranexamic acid for managing hemoptysis during bronchoscopy.
• To evaluate which agent might reduce the need for subsequent medical interventions.

Main Methods:

• A double-blind study involving 50 patients with hemoptysis uncontrolled by cold saline lavage.
• Patients received either adrenaline (1 mg) or tranexamic acid (500 mg) diluted in saline and instilled via bronchoscope.
• Treatment was repeated if necessary, with a second medication administered for persistent bleeding.

Main Results:

• No significant difference in the time to bleeding control between tranexamic acid and adrenaline groups (P=0.908).
• Fewer patients in the tranexamic acid group (4%) required a second medication compared to the adrenaline group (32%), though this difference was not statistically significant (P=0.609).

Conclusions:

• Endobronchial tranexamic acid is as effective as adrenaline in controlling hemoptysis.
• Tranexamic acid may offer an advantage by potentially reducing the need for additional medications.