• Curr Opin Crit Care · Sep 2024

    Is tranexamic acid appropriate for all patients undergoing high-risk surgery?

    • Ane Abad-Motos, Jose A García-Erce, Paolo Gresele, and Jose A Páramo.
    • Anesthesia and Critical Care Department, Donostia University Hospital, Donostia-San Sebastián.
    • Curr Opin Crit Care. 2024 Sep 9.

    Purpose Of ReviewTranexamic acid (TXA), an antifibrinolytic agent, reduces surgical bleeding in a variety of procedures, such as cardiac, orthopedic, abdominal, and urologic surgery, cesarean section, and neurosurgery. However, there are surgical interventions for which its use is not yet widespread, and some caution persists because of concerns regarding thrombotic risk. The purpose of this review is to analyze the most recent evidence in various subgroups of surgical specialties and the association of TXA with thrombotic events and other side effects (e.g. seizures).Recent FindingsRecent clinical trials and meta-analyses have shown that the efficacy and safety vary according to the clinical context, timing of administration, and dose. Some reports found that TXA reduces major bleeding by 25% without a significant increase in thrombotic events.SummaryWider use of TXA has the potential to improve surgical safety, avoid unnecessary blood use, and save healthcare funds.Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.

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