Aspects of tranexamic acid use in patients with severe trauma
Keywords:polytrauma, bleeding, tranexamic acid
Background. The article analyzes the impact of tranexamic acid use on the frequency of transfusion of blood components in patients with polytrauma. The purpose of our study was to find out the literature data on the use of tranexamic acid in patients with polytrauma and to analyze the frequency of blood components transfusion in patients with polytrauma, depending on time after injury onset. Materials and methods. We completed a retrospective cohort study and included 40 patients aged 22–56 years old with polytrauma. All patients were divided into group I — those who received tranexamic acid up to 3 hours after the onset of polytrauma and group II — tranexamic acid was administered within 3–8 hours after the onset of polytrauma. Results. The main multifactorial factors which lead to early coagulopathy in patients with polytrauma are the combination of hemorrhagic shock and tissue injury, which leads to the generation of a thrombin-thrombomodulin complex, activation of anticoagulant and fibrinolytic systems. Among the patients included in the data analysis in our study, the main causes of polytrauma were: traffic accidents — in 34 patients (85 %), falls from a height — in 6 patients (15 %). The mean age of patients in group I was 39.2 ± 17.3 years, in group II — 41.9 ± 12.8 years (p = 0.23). The study included 29 men and 11 women. There were no significant differences in the injury severity, the components of multiple organ failure, and anthropometric characteristics in both groups. We found that in group I, transfusions of erythrocyte mass and fresh frozen plasma were performed in 14 cases out of 26 (53 % of all cases of polytrauma in this group). In group II blood transfusions were completed in 9 cases of 14 (64 % of all cases in this group). The rate of transfusion of blood components in group II was 11 % higher than in group I (p ≥ 0.05). Conclusions. Our preliminary findings indicate that the administration of tranexamic acid up to 3 hours after polytrauma may reduce the incidence of hemotransfusions.
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