• Jeff Simmons, Robert A Sikorski, and Jean-Francois Pittet.
• aAnesthesia Services Division, Trauma Section, UAB Department of Anesthesiology, Birmingham, Alabama bDivision of Trauma Anesthesiology, Department of Anesthesiology, University of Maryland School of Medicine, and Perfusion and Cell Salvage Services, R Adams Cowley Shock Trauma Center, Baltimore, Maryland cCritical Care Division, Department of Anesthesiology, and Surgery and Cell Biology, Center for Lung Injury and Repair, University of Alabama at Birmingham, Birmingham, Alabama, USA.
• Curr Opin Anaesthesiol. 2015 Apr 1;28(2):191-200.

Purpose Of ReviewOptimizing hemostasis with antifibrinolytics is becoming a common surgical practice. Large clinical studies have demonstrated efficacy and safety of tranexamic acid (TXA) in the trauma population to reduce blood loss and transfusions. Its use in patients without pre-existing coagulopathies is debated, as thromboembolic events are a concern. In this review, perioperative administration of TXA is examined in nontrauma surgical populations. Additionally, risk of thromboembolism, dosing regimens, and timing of dosing are assessed.Recent FindingsPerioperative use of TXA is associated with reduced blood loss and transfusions. Thromboembolic effects do not appear to be increased. However, optimal dosing and timing of TXA administration is still under investigation for nontrauma surgical populations.SummaryAs part of a perioperative blood management programme, TXA can be used to help reduce blood loss and mitigate exposure to blood transfusion.

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