Lysine analogs inhibit the ability of plasmin to degrade crosslinked fibrin. As a result, these drugs have gained considerable interest in the management of complex derangements of hemostasis. A prospective, multicenter, observational study contained in this issue explores the laboratory evaluation of trauma patients who received tranexamic acid before hospital admission. Comparisons were made to propensity-matched historical controls. After assessing standard coagulation tests, blood gas analysis, and thromboelastography, it was noted that the tranexamic acid group demonstrated more favorable clot firmness and reduced levels of fibrin degradation products. Further trials are desired that pursue the study of clinical outcomes in the use of plasmin inhibitors.
1. Stein P, Studt J.-D., Albrecht R, et al. The impact of prehospital tranexamic acid on blood coagulation in trauma patients. Anesth Analg. 2018;126:522–529.