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Tranexamic acid in the prevention of periventricular haemorrhage
Insights
This study found tranexamic acid did not prevent periventricular haemorrhage in preterm infants. Excessive fibrinolytic activity is unlikely to be a major cause of this condition.
Area of Science:
- Neonatal neurology
- Hematology
Background:
- Periventricular haemorrhage (PVH) is a significant concern in preterm infants.
- Increased fibrinolytic activity in the brain's ganglionic eminence has been hypothesized as a cause of PVH.
Purpose of the Study:
- To evaluate the efficacy of tranexamic acid in preventing PVH in preterm infants.
- To investigate the role of fibrinolytic activity in the etiology of PVH.
Main Methods:
- A double-blind, randomized controlled trial was conducted with 100 preterm infants.
- Infants received either tranexamic acid or a placebo.
- Incidence of haemorrhage and levels of fibrin degradation products were monitored.
Main Results:
- Haemorrhages occurred in 22/100 infants receiving tranexamic acid and 20/100 receiving placebo.
- A significant reduction in fibrin degradation products was observed in the tranexamic acid group.
- The incidence of PVH was not significantly different between the groups.
Conclusions:
- Excessive fibrinolytic activity does not appear to be a primary factor in the development of PVH.
- Tranexamic acid is not effective in preventing PVH in this population.
Abstract:
Increased fibrinolytic activity in the ganglionic eminence of the preterm human brain has been proposed as a factor in the aetiology of periventricular haemorrhage. The effect of tranexamic acid in preventing periventricular haemorrhage was evaluated in 100 infants in a double blind, randomised controlled trial. Haemorrhages developed in 22 infants who received tranexamic acid and in 20 of those who received placebo. A significant reduction in fibrin degradation products in treated infants was seen. Our study suggests that excessive fibrinolytic activity is not an important factor in the aetiology of periventricular haemorrhage and that treatment with tranexamic acid will not prevent its occurrence.