Tranexamic Acid (TXA).

Around 25% of severe trauma patients experience acute coagulopathies associated with increased morbidity and mortality rates. Recently, we have seen an increased understanding of the relationship between trauma and alterations to the coagulation system. A little ironically, this knowledge has been gained largely from battlefield experience including Iraq and Afghanistan. Tranexamic Acid (TXA) is an antifibrinolytic. That is, it inhibits the activation of plasminogen (and plasmin) thereby preventing the breakdown of existing clots. One of the negative responses to an acute traumatic event is the muting of the bodies plasminogen activator inhibitor resulting in an increasing propensity for clot breakdown. You know how you just cannot resist picking away at that scab on your knee….even though you know you shouldn’t? Just like that. Although picking an internal scab might just kill you. Not all serve trauma patients go on to develop this coagulopathy, but those who do are more likely to die. And to die quick. TXA has been around since 1986, and was initially used to control heavy menstrual bleeding, its use spread to manage many bleeding abnormalities including haemophilia and post liver transplant management. CRASH–2 was a large, randomised, double-blinded, placebo-controlled, multicenter clinical trial (i.e. pretty much as good as it gets in the research world) on the use of TXA. The study found that for severely injured patients treated within 3 hours of injury had a sta...
Source: impactEDnurse - Category: Nurses Authors: Tags: the nurses desk: Source Type: blogs