title: Use of tranexamic acid in combat casualties. Experience of the Spanish medical corps. Clinical series and literature review.
abstract: OBJECTIVE
  To describe the experience with tranexamic acid (TXA) during the care of combat causalities treated in the Spanish military hospital based in Herat (Afghanistan) and to perform an analysis of the literature related to the military setting.
  
  
  METHODS
  With the approval of the appropriate military institutions, an analysis was performed on the use of TXA in combat casualties treated between March and May 2014. Of the 745 patients seen, 10 were due to a firearm/explosive device (combat casualties). A descriptive analysis was performed on the data collected. Absolute and relative frequencies (%) were used for the categorical variables. For central tendency measurements, the arithmetic mean and standard deviation or the median and interquartile range was calculated. The data were obtained from the military records of patients treated in the Herat military hospital.
  
  
  RESULTS
  All the patients in this series received TXA within the first 3 hours after the attack. The most frequent dose used was one gram i.v, with bleeding was controlled in 100% of cases. All the patients survived and none of them had secondary effects. These data agree with that recommended in the combat casualties treatment guide followed by military health in other countries in this setting.
  
  
  CONCLUSIONS
  All combat casualties were treated with TXA within the first 3 hours. The most frequent dose used was one gram iv and bleeding was controlled in all cases. All the patients survived with no adverse effects being observed.
authors.affiliation: Servicio de Cirugía Ortopédica y Traumatología, Hospital Universitario Central de la Defensa Gómez Ulla, Madrid, España. Electronic address: daniaedo@gmail.com.
authors.forename: D
authors.initials: D
authors.lastname: Aedo-Martín
authors.affiliation: Servicio de Cirugía Ortopédica y Traumatología, Hospital Universitario Central de la Defensa Gómez Ulla, Madrid, España.
authors.forename: R
authors.initials: R
authors.lastname: García-Cañas
authors.affiliation: Servicio de Anestesiología y Reanimación, Hospital Universitario Central de la Defensa Gómez Ulla, Instituto Mixto de Investigación Biosanitaria de la Defensa, Madrid, España.
authors.forename: R
authors.initials: R
authors.lastname: Navarro-Suay
authors.affiliation: Servicio de Cirugía Ortopédica y Traumatología, Hospital Universitario Central de la Defensa Gómez Ulla, Madrid, España.
authors.forename: M
authors.initials: M
authors.lastname: Martínez-Roldán
authors.affiliation: Servicio de Cirugía Ortopédica y Traumatología, Hospital Universitario Central de la Defensa Gómez Ulla, Madrid, España.
authors.forename: R
authors.initials: R
authors.lastname: Baños-Turza
authors.affiliation: Servicio de Cirugía Ortopédica y Traumatología, Hospital Universitario Central de la Defensa Gómez Ulla, Madrid, España.
authors.forename: R
authors.initials: R
authors.lastname: Tamburri-Bariain
mesh_terms: D000328:Adult; D055826:Afghan Campaign 2001-; D000346:Afghanistan; D000933:Antifibrinolytic Agents / Q000627:therapeutic use*; D004334:Drug Administration Schedule; D006772:Hospitals, Military; D006801:Humans; D008297:Male; D008889:Military Personnel; D012189:Retrospective Studies; D013030:Spain; D014148:Tranexamic Acid / Q000627:therapeutic use*; D016896:Treatment Outcome; D000067398:War-Related Injuries / Q000188:drug therapy*
chemical_list: D000933:Antifibrinolytic Agents; D014148:Tranexamic Acid
keywords: Baja de combate; Combat casualties; Gestión hemorragia del paciente; Hypovolaemic shock; Massive bleeding; Military health; Multiple injuries; Patient blood management; Politrauma; Sangrado masivo; Sanidad militar; Shock hipovolémico; Tranexamic acid; Ácido tranexámico