Universität zu Köln

Lier, H. and Maegele, M. (2019). Coagulation management: prehospital tranexamic acid. Pro and contra. Notfall Rettungsmed., 22 (8). S. 685 - 696. NEW YORK: SPRINGER. ISSN 1436-0578

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Abstract

The use of tranexamic acid (TXA), an antifibrinolytic drug, has received increasing attention in the coagulation management of severely injured patients. Based on the results of the prospective, multicenter Clinical Randomization of an Antifibrinolytic in Significant Hemorrhage-2 (CRASH-2) study with 20,211 patients, European experts were fairly quick to give high grading recommendations for TXA. However, the transferability of these results to modern trauma systems remains questionable and is doubted by some studies. Growing knowledge of trauma-induced coagulopathy with different phenotypes also impedes the universal application of TXA for all trauma patients. TXA is a medication; therefore, it requires an indication and has effects but also side effects. Especially in severely injured patients, TXA's current target population, some recent publications find a decreased mortality but increased thromboembolic effects. Only after evaluation of the results of current trials are evidence-based recommendations for prehospital application of TXA possible.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Lier, H. UNSPECIFIED UNSPECIFIED UNSPECIFIED Maegele, M. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-125030
DOI:	10.1007/s10049-018-0471-2
Journal or Publication Title:	Notfall Rettungsmed.
Volume:	22
Number:	8
Page Range:	S. 685 - 696
Date:	2019
Publisher:	SPRINGER
Place of Publication:	NEW YORK
ISSN:	1436-0578
Language:	German
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language FIBRINOLYSIS SHUTDOWN; TRAUMA PATIENTS; POSTINJURY FIBRINOLYSIS; MILITARY USE; HYPERFIBRINOLYSIS; RESUSCITATION; MORTALITY; INJURY; COAGULOPATHY; HEMORRHAGE Multiple languages Emergency Medicine Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/12503