Does tranexamic acid stop haemoptysis?: Table 1:

Moen, Christian Arvei; Burrell, Amy; Dunning, Joel

doi:10.1093/icvts/ivt383

Cited by 61 publications

(29 citation statements)

References 13 publications

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“…Mild and moderate haemoptysis usually responds to tranexamic acid (typically 500 mg three times daily), although not licensed for this indication (SoR A and QoE III) [118,119]. Tranexamic acid interferes with clot dissolution because it inhibits fibrinolysis and so increases infarction potential.…”

Section: Follow-upmentioning

confidence: 99%

Chronic pulmonary aspergillosis: rationale and clinical guidelines for diagnosis and management

Denning¹,

Cadranel²,

et al. 2015

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Chronic pulmonary aspergillosis (CPA) is an uncommon and problematic pulmonary disease, complicating many other respiratory disorders, thought to affect ∼240 000 people in Europe. The most common form of CPA is chronic cavitary pulmonary aspergillosis (CCPA), which untreated may progress to chronic fibrosing pulmonary aspergillosis. Less common manifestations include: Aspergillus nodule and single aspergilloma. All these entities are found in non-immunocompromised patients with prior or current lung disease. Subacute invasive pulmonary aspergillosis (formerly called chronic necrotising pulmonary aspergillosis) is a more rapidly progressive infection (<3 months) usually found in moderately immunocompromised patients, which should be managed as invasive aspergillosis. Few clinical guidelines have been previously proposed for either diagnosis or management of CPA. A group of experts convened to develop clinical, radiological and microbiological guidelines. The diagnosis of CPA requires a combination of characteristics: one or more cavities with or without a fungal ball present or nodules on thoracic imaging, direct evidence of Aspergillus infection (microscopy or culture from biopsy) or an immunological response to Aspergillus spp. and exclusion of alternative diagnoses, all present for at least 3 months. Aspergillus antibody (precipitins) is elevated in over 90% of patients. Surgical excision of simple aspergilloma is recommended, if technically possible, and preferably via video-assisted thoracic surgery technique. Long-term oral antifungal therapy is recommended for CCPA to improve overall health status and respiratory symptoms, arrest haemoptysis and prevent progression. Careful monitoring of azole serum concentrations, drug interactions and possible toxicities is recommended. Haemoptysis may be controlled with tranexamic acid and bronchial artery embolisation, rarely surgical resection, and may be a sign of therapeutic failure and/or antifungal resistance. Patients with single Aspergillus nodules only need antifungal therapy if not fully resected, but if multiple they may benefit from antifungal treatment, and require careful follow-up. @ERSpublications ERS and ESCMID guideline for the management of chronic pulmonary aspergillosis released

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Section: Follow-upmentioning

confidence: 99%

Chronic pulmonary aspergillosis: rationale and clinical guidelines for diagnosis and management

Denning¹,

Cadranel²,

et al. 2015

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“…Systemic tranexamic acid is associated with thromboembolic complications. (13,14) Nebulized tranexamic acid could potentially achieve rapid control of hemoptysis without systemic side effects. A recent randomized controlled trial reported the successful use of nebulized tranexamic acid for moderate hemoptysis (10) due to bronchiectasis, infection, or malignancy.…”

Section: Discussionmentioning

confidence: 99%

Nebulized Tranexamic Acid Therapy for Hemoptysis Associated with Submassive Pulmonary Embolism

Dhanani

Roberts

Reade

2020

Journal of Aerosol Medicine and Pulmonary Drug Delivery

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Hemoptysis and pulmonary embolism (PE) are life-threatening pulmonary emergencies that, when present together, create a therapeutic conundrum. We present an illustrative case of a 65-year-old man with unprovoked submassive PE and moderate hemoptysis due to pulmonary infarction. Hemoptysis precluded systemic anticoagulation. Failing a conservative management strategy, we administered nebulized tranexamic acid. After four doses of nebulized tranexamic acid 500 mg, 6 hours apart, hemoptysis had ceased. Systemic anticoagulation with intravenous heparin was then successfully commenced 12 hours after the last episode of hemoptysis. The patient was weaned off high-flow nasal oxygen therapy over the course of the next 5 days with no hemoptysis recurrence. Noting the absence of trial evidence, but good pharmacological rationale and our positive experience, we suggest tranexamic acid is a useful noninvasive treatment option for the management of such conditions. Consent for this publication was obtained from the patient.

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“…If the bleeding site is known, laying the patient in the lateral decubitus position on the side of the haemorrhage may help. Tranexamic acid may reduce bleeding duration and volume,2 but identifying the bleeding source may be critical in permitting life-saving treatment 3. Once the patient is stabilised, CT angiography can be used to identify the site of bleeding.…”

Section: Descriptionmentioning

confidence: 99%