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The many roles of tranexamic acid: An overview of the clinical indications for TXA in medical and surgical patients
Author(s) -
Cai Johnny,
Ribkoff Jessica,
Olson Sven,
Raghunathan Vikram,
AlSamkari Hanny,
DeLoughery Thomas G.,
Shatzel Joseph J.
Publication year - 2020
Publication title -
european journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 84
eISSN - 1600-0609
pISSN - 0902-4441
DOI - 10.1111/ejh.13348
Subject(s) - tranexamic acid , medicine , antifibrinolytic , hemostasis , hemostatic agent , intensive care medicine , broad spectrum , surgery , blood loss , chemistry , combinatorial chemistry
Clinically significant bleeding can occur as a consequence of surgery, trauma, obstetric complications, anticoagulation, and a wide variety of disorders of hemostasis. As the causes of bleeding are diverse and not always immediately apparent, the availability of a safe, effective, and non‐specific hemostatic agent is vital in a wide range of clinical settings, with antifibrinolytic agents often utilized for this purpose. Tranexamic acid (TXA) is one of the most commonly used and widely researched antifibrinolytic agents; its role in postpartum hemorrhage, menorrhagia, trauma‐associated hemorrhage, and surgical bleeding has been well defined. However, the utility of TXA goes beyond these common indications, with accumulating data suggesting its ability to reduce bleeding and improve clinical outcomes in the face of many different hemostatic challenges, without a clear increase in thrombotic risk. Herein, we review the literature and provide practical suggestions for clinical use of TXA across a broad spectrum of bleeding disorders.