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Is tranexamic acid appropriate for all patients undergoing high-risk surgery?
Ane Abad-Motos1,2, Jose A García-Erce3, Paolo Gresele4
1Anesthesia and Critical Care Department, Donostia University Hospital, Donostia-San Sebastián.
Current Opinion in Critical Care
|September 9, 2024
Summary
Tranexamic acid (TXA) effectively reduces surgical bleeding across many procedures. Recent evidence suggests TXA is safe and beneficial, with a 25% reduction in major bleeding without increasing thrombotic events.
Area of Science:
- Anesthesiology
- Hematology
- Surgical Sciences
Background:
- Tranexamic acid (TXA) is an antifibrinolytic agent used to reduce surgical bleeding.
- Its application is not yet widespread in all surgical specialties due to concerns about thrombotic risk.
- Recent evidence is reviewed to assess efficacy and safety in diverse surgical contexts.
Purpose of the Study:
- To analyze recent evidence on tranexamic acid (TXA) use in various surgical specialties.
- To evaluate the association of TXA with thrombotic events and other side effects.
- To assess the impact of TXA on surgical bleeding and patient outcomes.
Main Methods:
- Review of recent clinical trials and meta-analyses.
- Analysis of data stratified by surgical specialty, timing of administration, and dosage.
- Evaluation of reported thrombotic events and other adverse effects.
Main Results:
- TXA efficacy and safety profiles vary by clinical context, timing, and dose.
- Some studies indicate TXA reduces major bleeding by 25% without a significant increase in thrombotic events.
- Evidence on side effects like seizures is also considered.
Conclusions:
- Wider adoption of TXA can enhance surgical safety.
- TXA can help avoid unnecessary blood transfusions.
- Implementing TXA can lead to significant healthcare cost savings.
