Irish journal of medical science
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Case Reports
Generalized convulsion resulted in hyperammonemia during treatment with tranexamic acid for hemoptysis.
Tranexamic acid is commonly used to treat various kinds of bleeding disorders. It has been shown to cause severe convulsions in animal experiments. ⋯ This case highlights that generalized convulsion is a very rare, but serious adverse effect of tranexamic acid. Generalized convulsion should be considered as a potential cause of transient hyperammonemia.
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Enhanced recovery programmes have been studied in randomised trials with evidence of quicker recovery of gut function, reduced morbidity, mortality and hospital stay and improved physiological and nutritional outcomes. They aim to reduce the physiological and psychological stress of surgery and consequently the uncontrolled stress response. The key elements, reduced pre-operative fasting, intravenous fluid restriction and early feeding after surgery, are in conflict with traditional management plans but are supported by strong clinical evidence. Given the strength of the current data enhanced recovery should now be the standard of care.