Tranexamic Acid in Pediatric Care: A Comprehensive Overview.

Area of Science:

• Pediatric Emergency Medicine
• Hematology
• Pharmacology

Background:

• Tranexamic acid (TXA) is a hemostatic agent with proven benefits in adult trauma and surgery.
• Its application in pediatric medicine for hemorrhage management is less researched, with existing knowledge gaps.
• Inconsistent pediatric-specific clinical guidelines highlight the need for further investigation.

Purpose of the Study:

• To review the efficacy, pharmacokinetics, dosing, and safety of TXA in pediatric populations.
• To identify knowledge gaps and inconsistencies in the current use of TXA for children.
• To inform the development of standardized pediatric protocols for TXA administration.

Main Methods:

• A targeted literature search was performed using PubMed and Google Scholar.
• Keywords included MeSH terms related to TXA efficacy, pharmacokinetics, dosing, and safety in children (0-18 years).
• Studies published between 1995 and February 2025 were included.

Main Results:

• TXA demonstrates efficacy in reducing blood loss, transfusion needs, and improving survival in pediatric trauma, surgery, and emergencies.
• Nebulized TXA shows potential for specific conditions like post-tonsillectomy hemorrhage.
• Significant gaps remain regarding age-specific pharmacokinetics, long-term safety, thromboembolic risks, and seizure risks.

Conclusions:

• TXA is critical for pediatric hemorrhagic emergencies, improving survival and outcomes.
• Further interdisciplinary research, standardized pediatric guidelines, and enhanced provider training are essential.
• Addressing knowledge gaps is key to safe and effective TXA implementation in diverse pediatric settings.