Related Experiment Video
Updated: Jun 11, 2026
Microfluidics in Assessing Platelet Function
Published on: November 8, 2024
Efficacy and Safety of Tranexamic Acid in Pediatric Trauma: A Systematic Review and Meta-Analysis
Mohammed Alsabri1,2, Yahya A Mahmoud3, Amira A Aboali4
1Emergency Department (MA), Althawara Modern General Hospital, Sanaa, Yemen.
Insights
Tranexamic acid (TXA) may shorten hospital stays for pediatric trauma patients but has inconsistent effects on mortality and adverse events. Individualized use based on injury severity is recommended, with further research needed.
Area of Science:
- Trauma Care
- Pediatric Medicine
- Pharmacology
Background:
- Tranexamic acid (TXA) is an antifibrinolytic agent commonly used in adult surgical and trauma settings.
- Its efficacy and safety in pediatric trauma patients require thorough evaluation.
Purpose of the Study:
- To assess the effectiveness and safety of tranexamic acid (TXA) in pediatric trauma patients.
- To analyze the impact of TXA on various clinical outcomes, including mortality, hospital stay, and adverse events.
Main Methods:
- A systematic literature review was conducted across four databases.
- Included studies comprised randomized controlled trials and observational studies involving pediatric trauma patients (≤18 years).
- Meta-analyses were performed to synthesize data on clinical outcomes and safety events.
Main Results:
- 12 studies involving 66,398 pediatric trauma patients were analyzed.
- TXA was associated with significantly shorter hospital stays (MD = -1.49 days).
- No significant reduction in hospital mortality was observed; however, increased need for emergency mechanical ventilation was noted, with decreased need at discharge. Thromboembolic events and neurological outcomes were not significantly altered.
Conclusions:
- Tranexamic acid (TXA) may reduce hospital length of stay in pediatric trauma patients.
- The effects of TXA on mortality and adverse events are inconsistent.
- Individualized treatment decisions considering injury severity and resource availability are crucial, necessitating further high-quality research.
Objective:
Tranexamic acid (TXA) is a widely used antifibrinolytic agent in surgical and trauma settings in adults. This study aimed to evaluate the efficacy and safety of TXA in pediatric trauma patients across various clinical outcomes.
Methods:
A comprehensive literature search was conducted across 4 databases. We included clinical trials and observational studies that reported the use of TXA in pediatric trauma patients (aged ≤18 years). Data extraction and risk-of-bias assessment were performed by independent reviewers. Meta-analyses were conducted with RStudio software.
Results:
A total of 12 studies (2 randomized controlled trials [RCTs] and 10 observational) involving 66,398 pediatric trauma patients were included. Tranexamic acid was not significantly associated with reduction in hospital mortality (OR = 1.06; 95% CI, 0.32-3.45) but was associated with significantly shorter hospital stays (mean difference [MD] = -1.49; 95% CI, -2.43 to -0.56). The need for emergency mechanical ventilation was higher among the TXA group (OR = 4.29; 95% CI, 2.52-7.31), whereas the need for mechanical ventilation at discharge was lower (OR = 0.23; 95% CI, 0.08-0.64). Tranexamic acid use did not significantly alter the risk of thromboembolic events (OR = 0.72; 95% CI, 0.19-2.79) or poor neurological outcomes (OR = 2.51; 95% CI, 0.86-7.35).
Conclusion:
Tranexamic acid may reduce hospital length of stay in pediatric trauma patients, with inconsistent effects on mortality and adverse events. Its use should be individualized based on injury severity and resource availability. Further high-quality research is needed to confirm these findings and clarify the role of TXA in pediatric trauma care.
