Trauma leads to bleeding. Bleeding needs clots. Anti-fibrinolytics stop clot breakdown. Tranexamic acid is an anti-fibrinolytic. In fact, trauma often leads to a ‘hyper-fibrinolysis’, making the use of early anti-fibrinolytics potentially more useful.
So it would make sense then that tranexamic acid would lead to a reduction in bleeding in trauma, and this article in The Lancet goes on to say just that. Over 20,000 patients were given tranexamic acid (1 gram now, then 1 gram over 8 hours), and the result?
All cause mortality was less (RR 0.91) and bleeding rates were less (RR 0.85).”Tranexamic acid should be conisdered for use in bleeding trauma patients”, say the authors – make up your own mind here.