Use of tranexamic acid in combat casualties. Experience of the Spanish medical corps. Clinical series and literature review

Aedo-Martín, Daniel; Cañas, R. García; Suay, R. Navarro; Martínez-Roldán, M.; Baños-Turza, R.; Tamburri-Bariain, R

doi:10.1016/j.recote.2016.03.006

Cited by 5 publications

(3 citation statements)

References 29 publications

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“…We defined case studies and case series as n < 10 and therefore two studies were excluded. These were Aedo-Martin (2016) and Chesters (2015) [17,18].…”

Section: Resultsmentioning

confidence: 99%

Geographical Variance in the Use of Tranexamic Acid for Major Trauma Patients

2019

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Background and Objectives: The CRASH-2 trial is the largest randomised control trial examining tranexamic acid (TXA) for injured patients. Since its publication, debate has arisen around whether results could be applied to mature trauma systems in developed nations, with global opinion divided. The aim of this study was to determine if, among trauma patients in or at significant risk of major haemorrhages, there is an association of geographic region with the proportion of patients that received tranexamic acid. Materials and Methods: We conducted a systematic review of the literature. Potentially eligible papers were first screened via title and abstract screening. A full copy of the remaining papers was then obtained and screened for final inclusion. The Newcastle–Ottawa Scale for non-randomised control trials was used for quality assessment of the final studies included. A meta-analysis was conducted using a random-effects model, reporting variation in use sub-grouped by geographical location. Results: There were 727 papers identified through database searching and 23 manuscripts met the criteria for final inclusion in this review. There was a statistically significant variation in the use of TXA for included patients. Europe and Oceania had higher usage rates of TXA compared to other continents. Use of TXA in Asia and Africa was significantly less than other continents and varied use was observed in North America. Conclusions: A large geographical variance in the use of TXA for trauma patients in or at significant risk of major haemorrhage currently exists. The populations in Asia and Africa, where the results of CRASH-2 could be most readily generalised to, reported low rates of use. The reason why remains unclear and further research is required to standardise the use of TXA for trauma resuscitation.

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“…We defined case studies and case series as n < 10 and therefore two studies were excluded. These were Aedo-Martin (2016) and Chesters (2015) [17,18].…”

Section: Resultsmentioning

confidence: 99%

Geographical Variance in the Use of Tranexamic Acid for Major Trauma Patients

2019

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“…It has been reported that TXA reduces mortality in trauma patients and seems to be most beneficial if given within 3 hours after injury [99]. In the past few years, TXA has drawn much attention for prehospital use in military [39,[100][101][102] and civilian practice [40]. Overall available data in the literature, including CRASH-2 (Clinical Randomisation of an Antifibrinolytic in Significant Hemorrhage 2) [103] and the WOMAN Trial (World Maternal Antifibrinolytic Trial) [104], corroborate the efficacy and safety of TXA.…”

Section: Tranexamic Acidmentioning

confidence: 99%

Hemostatic agents for prehospital hemorrhage control: a narrative review

Peng

2020

Military Med Res

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Hemorrhage is the leading cause of preventable death in combat trauma and the secondary cause of death in civilian trauma. A significant number of deaths due to hemorrhage occur before and in the first hour after hospital arrival. A literature search was performed through PubMed, Scopus, and Institute of Scientific Information databases for English language articles using terms relating to hemostatic agents, prehospital, battlefield or combat dressings, and prehospital hemostatic resuscitation, followed by cross-reference searching. Abstracts were screened to determine relevance and whether appropriate further review of the original articles was warranted. Based on these findings, this paper provides a review of a variety of hemostatic agents ranging from clinically approved products for human use to newly developed concepts with great potential for use in prehospital settings. These hemostatic agents can be administered either systemically or locally to stop bleeding through different mechanisms of action. Comparisons of current hemostatic products and further directions for prehospital hemorrhage control are also discussed.

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“…One study demonstrated that intravenous administration of TXA resulted in a decrease in mortality by 17.4-23.9% in trauma settings (48,51). Additionally, numerous studies published data in support of intravenous TXA administration in prehospital and combat settings (52)(53)(54)(55).…”

Section: Txamentioning

confidence: 99%

Emerging approaches to pre-hospital hemorrhage control: a narrative review

Jamal

Saini²,

Quencer³

et al. 2021

Ann Transl Med

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In the United States, trauma claims the lives of over 150,000 civilians each year. In military settings, trauma and exsanguination result in 50% of combat related deaths. The majority of these deaths result from uncontrolled non-compressible hemorrhage. Non-compressible hemorrhage often results from deep vascular injuries within the torso, however can also occur secondary to penetrating injuries that involve the extremities. Given the high mortality rates for non-compressible hemorrhage, rapid and effective management of patients suffering from hemorrhage is essential to good patient outcomes. Consequently, there has been increasing interest in solutions for point-of-injury hemorrhage control in trauma and military medicine. Undoubtedly there is a great need for prehospital hemostatic interventions that can be deployed by trained and untrained personnel. Since 2001, various hemostatic agents have been developed, each with its advantages based upon the type and severity of injury, wound size, wound location, accessibility to injury site, and the coagulation status of the patient. These agents are often used in the military setting as a temporizing measure prior to definitive therapy and include techniques such as resuscitative endovascular balloon occlusion of the aorta (REBOA) and bioengineered agents including ResQFoam, RevMedx's XSTAT, Tranexamic acid (TXA), and QuikClot Combat Gauze (QCG). Here, we review the indications, composition, technique, efficacy, and outcomes of these hemostatic agents.

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Use of tranexamic acid in combat casualties. Experience of the Spanish medical corps. Clinical series and literature review

Cited by 5 publications

References 29 publications

Geographical Variance in the Use of Tranexamic Acid for Major Trauma Patients

Geographical Variance in the Use of Tranexamic Acid for Major Trauma Patients

Hemostatic agents for prehospital hemorrhage control: a narrative review

Emerging approaches to pre-hospital hemorrhage control: a narrative review

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