Related Experiment Video
Updated: Jul 13, 2025
05:31
Transradial Access Chemoembolization for Hepatocellular Carcinoma Patients
Published on: September 20, 2020
5.6K
Thromboembolic Complications Following Perioperative Tranexamic Acid Administration
Ella C Eisinger1, Liam Forsythe2, Sarah Joergensen2
1Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.
The Journal of Surgical Research
|October 15, 2023
Summary
Empirically administered tranexamic acid (TXA) did not increase mortality or venous thromboembolism (VTE) in trauma patients. However, TXA use was associated with higher transfusion volumes, suggesting its safety but warranting further research for targeted application.
Area of Science:
- Trauma care
- Pharmacology
- Critical care medicine
Background:
- Antifibrinolytic tranexamic acid (TXA) is used in trauma to reduce death.
- Its use in patients without confirmed hyperfibrinolysis and its association with complications remain unclear.
Purpose of the Study:
- To analyze the associations of empirically administered TXA in trauma patients.
- To determine if TXA use correlates with lower transfusion volumes and increased thromboembolic complications.
Main Methods:
- Retrospective cohort study of trauma patients on massive transfusion protocol (2016-2021).
- Comparison of patients who received TXA versus those who did not.
- Primary outcome: in-hospital mortality. Secondary outcomes: venous thromboembolism (VTE), transfusion volumes, coagulation measures.
- Statistical analyses included descriptive statistics, univariate analyses, and multivariable logistic regression.
Main Results:
- TXA patients had lower presenting systolic blood pressure, higher injury severity scores, and were more likely to have undergone emergency surgery.
- After adjustment, TXA was not significantly associated with mortality or VTE.
- TXA patients received significantly larger volumes of packed red blood cells, platelets, and plasma within 4 and 24 hours.
- No differences in clot stability were observed via thromboelastography.
Conclusions:
- Empiric TXA administration in trauma patients was not associated with increased mortality or VTE.
- TXA use was linked to higher transfusion requirements, potentially due to more severe bleeding.
- The safety of TXA in this cohort supports its use, but further research is needed to optimize its application.
Related Concept Videos
01:29Venous Thrombosis III: Interprofessional Care
10
Venous thrombosis requires effective prevention and treatment strategies to improve patient outcomes and reduce potential complications.Prevention StrategiesHealthcare providers must prioritize preventing venous thromboembolism (VTE) for all adult patients upon admission. Interventions depend on bleeding and thrombosis risk, medical history, current medications, diagnoses, planned procedures, and patient preferences. Patients on bed rest should change positions every two hours and, if not...
10
01:30Venous Thrombosis IV: Nursing Management
14
Nursing management begins with a thorough assessment of the patient's health history. Key factors include trauma to veins, peripherally inserted central catheters, varicose veins, recent pregnancy or childbirth, surgery, bacteremia, prolonged bed rest, atrial fibrillation, COPD, heart failure, cancer, coagulation disorders, myocardial infarction, spinal cord injury, stroke, prolonged travel, recent bone fractures, and dehydration. Review medication intake, particularly oral contraceptives,...
14
01:29Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care
10
Diagnosing Pulmonary EmbolismDiagnosing pulmonary embolism (PE) involves clinical assessment and advanced imaging tests. The preferred diagnostic tool is the spiral (helical) CT scan or CT angiography (CTA), which uses intravenous contrast media to visualize the pulmonary vasculature and identify emboli.A ventilation-perfusion (V/Q) scan is an alternative for patients unable to receive contrast media. This scan includes both perfusion and ventilation scanning. Perfusion scanning involves...
10
01:30Anticoagulant Drugs: Low-Molecular-Weight Heparins
726
Hemostasis is a crucial process that prevents excessive blood loss from damaged blood vessels. It involves various mechanisms such as vasoconstriction, platelet adhesion and activation, and fibrin formation. The importance of each mechanism depends on the type of vessel injury. In contrast, thrombosis is the abnormal formation of a blood clot within the blood vessels, leading to potential complications if the clot obstructs blood flow. Thrombosis can be caused by increased coagulability of the...
726
01:27Pulmonary Embolism III: Nursing Management
15
A pulmonary embolism occurs when a thrombus, amniotic fluid, tumor tissue, fat, or air embolus blocks one or more pulmonary arteries. Effective nursing management and patient education are crucial for improving outcomes and preventing recurrence.Nursing management starts with obtaining a comprehensive patient history, particularly noting any history of deep vein thrombosis (DVT). Assess for clinical manifestations, including dyspnea, chest pain, crackles, heart murmurs, and signs of right-sided...
15
01:23Peripheral Artery Disease V: Postoperative Nursing Management
12
During the postoperative period, it is crucial to focus on maintaining circulation, identifying and managing potential complications, and planning for discharge.Nursing AssessmentVital signs monitoring: Regularly monitor vital signs, including blood pressure, heart rate, respiratory rate, and temperature, to detect early signs of complications such as bleeding and infection.Circulation assessment: Monitor pulses, perform Doppler assessments, and check capillary refill, color, temperature, and...
12