• Andrew P Cap, David G Baer, Jean A Orman, James Aden, Kathy Ryan, and Lorne H Blackbourne.
• US Army Institute of Surgical Research, Fort Sam Houston, Texas 78234, USA. andre.p.cap@us.army.mil
• J Trauma. 2011 Jul 1;71(1 Suppl):S9-14.

BackgroundTranexamic acid (TXA) is an antifibrinolytic that inhibits both plasminogen activation and plasmin activity, thus preventing clot break-down rather than promoting new clot formation. TXA has been used around the world to safely control bleeding since the 1960s. A large randomized trial recently conducted in >20,000 trauma patients adds to the large body of data documenting the usefulness of TXA in promoting hemostasis.MethodsWe reviewed the literature describing use of TXA in a variety of settings including trauma.ResultsTXA has been safely used across a wide range of clinical settings to control hemorrhage. The results of a large, randomized, placebo-controlled trial support the use of TXA to treat bleeding trauma patients.ConclusionsThis inexpensive and safe drug should be incorporated into trauma clinical practice guidelines and treatment protocols. Further research on possible alternate mechanisms of action and dosing regimens for TXA should be undertaken. Concurrent to these endeavors, TXA should be adopted for use in bleeding trauma patients because it is the only drug with prospective clinical evidence to support this application.

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