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‘Massive transfusion protocols and the use of tranexamic acid

Godbey, Elizabeth A.a; Schwartz, Josephb

doi: 10.1097/MOH.0000000000000457

Purpose of review We review recent articles pertaining to the use of tranexamic acid (TXA) in populations at risk for massive transfusion. Although there are no recent studies that specifically examine the use of TXA in massive transfusion protocols (MTPs), there are a few studies with subgroups of massive transfusion patients.

Recent findings In recent years, many publications have discussed outcomes and safety associated with the addition of TXA to treatment plans for bleeding pediatric, trauma, and postpartum hemorrhage patients. In general, TXA appears to decrease mortality and transfusion requirements.

Summary TXA was shown to decrease mortality in several bleeding populations. It is now a common addition to MTPs. There is conflicting evidence regarding the potential of TXA as a risk factor for thrombotic events. Ongoing studies should provide additional evidence regarding the thrombotic risk of TXA in massive transfusion.

aVirginia Commonwealth University Health System, Richmond, Virginia, USA

bColumbia University Irving Medical Center, New York, New York, USA

Correspondence to Elizabeth A. Godbey, MD, VCU Health System, Richmond, VA, 23298 USA. E-mail:

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