Tranexamic acid: less bleeding and less thrombosis?
1 Department of Anesthesia and Critical Care, Hotel-Dieu and Cochin Hospitals, Paris Descartes University, 75004, Paris, France
2 Department of Thrombosis and Vascular Biology, Rayne Institute, 4th Floor, Lambeth Wing, St. Thomas' Hospital, Westminster Bridge Road, London SE1 7EH, UK
3 Clinical Trials Unit, London School of Hygiene and Tropical Medicine, Keppel Street,London WC1E 7HT, UK
4 Thrombosis and Haemostasis Centre, Guy's and St Thomas's NHS Foundation Trusts, and King's College, London, SE1 7EH, UK
5 St Thomas' Hospital, Westminster Bridge Road, London, SE1 7EH, UK
Critical Care 2012, 16:135 doi:10.1186/cc11374Published: 29 June 2012
The early administration of tranexamic acid (TXA) to bleeding trauma patients reduces all-cause mortality without increasing the risk of vascular occlusive events. Indeed, the risk of arterial thrombosis appears to be reduced with TXA. In this commentary we hypothesize that TXA has an antithrombotic effect and explore potential mechanisms. These include inhibition of the inflammatory effects of plasmin, effects on platelets and effects on factors V and VIII. If proven, these antithrombotic effects would have major implications for the systemic use of TXA in surgical patients, where TXA has been clearly shown to reduce bleeding.