Secondary Logo

 TXA, PCC and Fibrinogen

Watch the video, claim CME credit!

Visit the AAST’s e-learning site for an ACCME-accredited activity associated with this video.


TXA, PCC and Fibrinogen
AAST Grand Round, June 2014


Presented by: Bryan Cotton, MD

Moderated by: Joseph Galante, MD


Referenced in presentation:


Do all trauma patients benefit from tranexamic acid?
Valle EJ, Allen CJ, Van Haren RM, Jouria JM, Li H, Livingstone AS, Namias N, Schulman CI, Proctor KG.
J Trauma Acute Care Surg. 2014 Jun;76(6):1373-8.


Fibrinolysis greater than 3% is the critical value for initiation of antifibrinolytic therapy.
Chapman MP, Moore EE, Ramos CR, Ghasabyan A, Harr JN, Chin TL, Stringham JR, Sauaia A, Silliman CC, Banerjee A.
J Trauma Acute Care Surg. 2013 Dec;75(6):961-7; discussion 967.


Tranexamic acid in trauma: how should we use it?
Napolitano LM, Cohen MJ, Cotton BA, Schreiber MA, Moore EE.
J Trauma Acute Care Surg. 2013 Jun;74(6):1575-86.


Administration of fibrinogen concentrate in exsanguinating trauma patients is associated with improved survival at 6 hours but not at discharge.
Wafaisade A, Lefering R, Maegele M, Brockamp T, Mutschler M, Lendemans S, Banerjee M, Bouillon B, Probst C; Trauma Registry of DGU.
J Trauma Acute Care Surg. 2013 Feb;74(2):387-3; discussion 393-5.


Hyperfibrinolysis at admission is an uncommon but highly lethal event associated with shock and prehospital fluid administration.
Cotton BA, Harvin JA, Kostousouv V, Minei KM, Radwan ZA, Schöchl H, Wade CE, Holcomb JB, Matijevic N.
J Trauma Acute Care Surg. 2012 Aug;73(2):365-70; discussion 370.


Criteria for empiric treatment of hyperfibrinolysis after trauma.
Kutcher ME, Cripps MW, McCreery RC, Crane IM, Greenberg MD, Cachola LM, Redick BJ, Nelson MF, Cohen MJ.
J Trauma Acute Care Surg. 2012 Jul;73(1):87-93.


Factor IX complex for the correction of traumatic coagulopathy.
Joseph B, Amini A, Friese RS, Houdek M, Hays D, Kulvatunyou N, Wynne J, O'Keeffe T, Latifi R, Rhee P.
J Trauma Acute Care Surg. 2012 Apr;72(4):828-34.


Aged plasma transfusion increases mortality in a rat model of uncontrolled hemorrhage.
Letourneau PA, McManus M, Sowards K, Wang W, Wang YW, Matijevic N, Pati S, Wade CE, Holcomb JB.
J Trauma. 2011 Nov;71(5):1115-9.


Protective effects of fresh frozen plasma on vascular endothelial permeability, coagulation, and resuscitation after hemorrhagic shock are time dependent and diminish between days 0 and 5 after thaw.
Pati S, Matijevic N, Doursout MF, Ko T, Cao Y, Deng X, Kozar RA, Hartwell E, Conyers J, Holcomb JB.
J Trauma. 2010 Jul;69 Suppl 1:S55-63.

Further reading:

Fibrinogen and platelet contributions to clot formation: implications for trauma resuscitation and thromboprophylaxis.
Kornblith LZ, Kutcher ME, Redick BJ, Calfee CS, Vilardi RF, Cohen MJ.
J Trauma Acute Care Surg. 2014 Feb;76(2):255-6; discussion 262-3.


The effects of tranexamic acid and prothrombin complex concentrate on the coagulopathy of trauma: an in vitro analysis of the impact of severe acidosis.
Porta CR, Nelson D, McVay D, Salgar S, Eckert M, Izenberg S, Martin MJ.
J Trauma Acute Care Surg. 2013 Dec;75(6):954-60


Anticoagulant and antiplatelet medications encountered in emergency surgery patients: a review of reversal strategies.
Gordon JL, Fabian TC, Lee MD, Dugdale M.
J Trauma Acute Care Surg. 2013 Sep;75(3):475-86.


New anticoagulants: A concise review.
Baumann Kreuziger LM, Morton CT, Dries DJ.
J Trauma Acute Care Surg. 2012 Oct;73(4):983-92.