Articles That May Change Your Practice: Tranexamic Acid Revisited

Published:December 28, 2020DOI:
      Tranexamic acid (TXA) is a synthetic derivative of the amino acid lysine that inhibits fibrinolysis by blocking the lysine-binding site on plasminogen. The Clinical Randomization of an Antifibrinolytic in Significant Haemorrhage 2 (CRASH-2) study examined the effects of early administration of a short course of TXA in trauma patients. Publication of this landmark study and the data regarding the safety profile of TXA have led to its liberal use for many clinical situations in which hemorrhage poses an immediate threat to life. However, the evidence to support this practice has been either scant or absent. In this issue, we summarize recently published evidence to help guide TXA use in an evidence-based manner.
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      Russell D. MacDonald, MD, MPH, FCFP, FRCPC, is the medical director at Ornge Transport Medicine; medical director at Toronto Paramedic Services; an associate professor in the Faculty of Medicine at the University of Toronto; and an attending staff member at Sunnybrook Health Sciences Centre in Toronto, Ontario, Canada. He can be reached at [email protected].