Acta Scientific Medical Sciences (ISSN: 2582-0931)

Editorial Volume 4 Issue 10

Early Use of Tranexamic Acid in Gastrointestinal Bleed

Pahnwat Tonya Taweesedt1 and Salim Surani2*

1Fellow, Pulmonary Medicine, Corpus Christi Medical Center, Texas, USA
2Adjunct Clinical Professor, Texas A&M University, Texas, USA

*Corresponding Author: Salim Surani, Adjunct Clinical Professor, Texas A&M University, Texas, USA.

Received: August 20, 2020; Published: August 31, 2020


Gastrointestinal (GI) bleeding is one of the causes leading to death worldwide. Approximately 47/100,000 for upper gastrointestinal bleeding (UGIB) and 33/100,000 for lower gastrointestinal bleeding (LGIB) [1]. Intravenous fluid, blood products, medications, surgical, and endoscopy procedure have been used as the treatment for GI bleeding. Tranexamic acid (TXA) has been proposed as one of the medications that reduced mortality in GI bleeding [2]. It is an anti-fibrinolytic agent that reduces bleeding in many clinical conditions especially in trauma settings [3]. However, the current guidelines do not recommend tranexamic acid for UGIB or LGIB treatment [4,5].



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  2. Bennett C., et al. “Tranexamic acid for upper gastrointestinal bleeding”. Cochrane Database System Review 11 (2014).
  3. Fischer K., et al. “Role of Tranexamic Acid in the Clinical Setting”. Cureus 12.5 (2020): e8221. 
  4. Overview | Acute upper gastrointestinal bleeding in over 16s: management | Guidance | NICE (2020).
  5. Oakland K., et al. “Diagnosis and management of acute lower gastrointestinal bleeding: guidelines from the British Society of Gastroenterology”. Gut 68.5 (2019): 776-789. 
  6. Roberts I., et al. “The CRASH-2 trial: a randomised controlled trial and economic evaluation of the effects of tranexamic acid on death, vascular occlusive events and transfusion requirement in bleeding trauma patients”. Health Technology Assessment 17.10 (2013): 1-79. 
  7. CRASH-3 trial collaborators. “Effects of tranexamic acid on death, disability, vascular occlusive events and other morbidities in patients with acute traumatic brain injury (CRASH-3): a randomised, placebo-controlled trial”. Lancet 394.10210 (2020): 1713-1723. 
  8. CRASH-2 collaborators., et al. “The importance of early treatment with tranexamic acid in bleeding trauma patients: an exploratory analysis of the CRASH-2 randomised controlled trial”. Lancet 377.9771 (2011): 1096-101, 1101.e1-2. 
  9. WOMAN Trial Collaborators. “Effect of early tranexamic acid administration on mortality, hysterectomy, and other morbidities in women with post-partum haemorrhage (WOMAN): an international, randomised, double-blind, placebo-controlled trial”. Lancet 389.10084 (2017): 2105-2116. 
  10. Gayet-Ageron A., et al. “Effect of treatment delay on the effectiveness and safety of antifibrinolytics in acute severe haemorrhage: a meta-analysis of individual patient-level data from 40 138 bleeding patients”. Lancet 391.10116 (2018): 125-132. 
  11. Twum-Barimah E., et al. “Systematic review with meta-analysis: the efficacy of tranexamic acid in upper gastrointestinal bleeding”. Alimentary Pharmacology and Therapeutics 51.11 (2018): 1004-1013. 
  12. Smith SR., et al. “Tranexamic Acid for Lower GI Hemorrhage: A Randomized Placebo-Controlled Clinical Trial”. Diseases of the Colon and Rectum 61.1 (2018): 99-106. 
  13. Biggs JC., et al. “Tranexamic acid and upper gastrointestinal haemorrhage--a double-blind trial”. Gut 17.9 (1976): 729-734. 
  14. Cormack F., et al. “Tranexamic acid in upper gastrointestinal hæmorrhage”. The Lancet 301.7814 (1973): 1207-1208. 
  15. Saidi H., et al. “Role of Intra-Gastric Tranexamic Acid in Management of Acute Upper Gastrointestinal Bleeding”. IIOAB Journal 8.1 (2017): 76-81. 
  16. Engqvist A., et al. “Tranexamic acid in massive haemorrhage from the upper gastrointestinal tract: a double-blind study”. Scandinavian Journal of Gastroenterology 14.7 (1979): 839-844. 
  17. Hawkey G., et al. “Drug treatments in upper gastrointestinal bleeding: value of endoscopic findings as surrogate end points”. Gut 49.3 (2001): 372-379. 
  18. HALT-IT Trial Collaborators. “Effects of a high-dose 24-h infusion of tranexamic acid on death and thromboembolic events in patients with acute gastrointestinal bleeding (HALT-IT): an international randomised, double-blind, placebo-controlled trial”. Lancet 395.10241 (2020): 1927-1936. 


Citation: Pahnwat Tonya Taweesedt and Salim Surani. “Early Use of Tranexamic Acid in Gastrointestinal Bleed". Acta Scientific Medical Sciences 4.10 (2020): 01-02.


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