Medication May Be Used to Save the Lives of Thousands of Trauma Patients Each Year
It was recently reported in the medical journal the Lancet that bleeding trauma patients who were the given the drug tranexamic acid, abbreviated TXA, had a reduced incidence of bleeding to death by about fifteen percent. Give the huge number of trauma victims around the world, the use of this medication could be potentially life saving for thousands of them. But what is tranexamic acid?
Tranexamic acid is medication which is frequently used during surgery to stop excessive bleeding. Specifically it inhibits the activation of plasgminogen to plasmin. Plasmin normally acts to break up fibrin, which is what blood clots are primarily made of. Thus by decreasing the amount of plasmin in the body, TXA allows blood clots made primarily of fibrin to remain intact. Thus trauma patients who often bleed to death, would have their blood clots stabilized thus preventing the loss of excessive blood.
But does TXA increase the risk of other types of blood clots, like strokes?
Presumably, the administration of TXA in trauma victims would last only long enough for the patient to stabilized, thus decreasing the risk of a deep vein thrombosis or stroke. Studies in women who received TXA to stop excessive bleeding related to uterine fibroids did not reveal an increased risk of pathological blood clot formation, or thrombosis. Hence oral TXA tablets are being used for the treatment of dysfunctional uterine bleeding.
And since TXA is produced generically, this is a new treatment for trauma victims which could be used in a variety of countries, including those with limited health care budgets.
However, follow up studies will likely be needed to assess the drug's safety profile in a wide population of trauma victims, and to see if anyone should be excluded from receiving the medication. Hypotension may occur if the drug is injected too quickly, thus slower administration may be required as trauma patients are more vulnerable to hypotension than the average patient.
Nonetheless, thousands of trauma patients may be given TXA in ERs, or in the field, in the coming years in the United States.