title: Tranexamic acid for trauma patients: a critical review of the literature.
abstract: BACKGROUND
  Tranexamic acid (TXA) is an antifibrinolytic that inhibits both plasminogen activation and plasmin activity, thus preventing clot break-down rather than promoting new clot formation. TXA has been used around the world to safely control bleeding since the 1960s. A large randomized trial recently conducted in >20,000 trauma patients adds to the large body of data documenting the usefulness of TXA in promoting hemostasis.
  
  
  METHODS
  We reviewed the literature describing use of TXA in a variety of settings including trauma.
  
  
  RESULTS
  TXA has been safely used across a wide range of clinical settings to control hemorrhage. The results of a large, randomized, placebo-controlled trial support the use of TXA to treat bleeding trauma patients.
  
  
  CONCLUSIONS
  This inexpensive and safe drug should be incorporated into trauma clinical practice guidelines and treatment protocols. Further research on possible alternate mechanisms of action and dosing regimens for TXA should be undertaken. Concurrent to these endeavors, TXA should be adopted for use in bleeding trauma patients because it is the only drug with prospective clinical evidence to support this application.
authors.affiliation: US Army Institute of Surgical Research, Fort Sam Houston, Texas 78234, USA. andre.p.cap@us.army.mil
authors.forename: Andrew P
authors.initials: AP
authors.lastname: Cap
authors.forename: David G
authors.initials: DG
authors.lastname: Baer
authors.forename: Jean A
authors.initials: JA
authors.lastname: Orman
authors.forename: James
authors.initials: J
authors.lastname: Aden
authors.forename: Kathy
authors.initials: K
authors.lastname: Ryan
authors.forename: Lorne H
authors.initials: LH
authors.lastname: Blackbourne
mesh_terms: D000933:Antifibrinolytic Agents / Q000627:therapeutic use*; D002986:Clinical Trials as Topic; D006470:Hemorrhage / Q000188:drug therapy; D006801:Humans; D015601:Injury Severity Score; D014148:Tranexamic Acid / Q000627:therapeutic use*; D014947:Wounds and Injuries / Q000188:drug therapy*
chemical_list: D000933:Antifibrinolytic Agents; D014148:Tranexamic Acid