Protest Trial: TXA vs Saline

Launched by SPECTRUM HEALTH HOSPITALS · May 17, 2024

Keywords

ClinConnect Summary

Tranexamic acid (TXA) is an antifibrinolytic agent. It forms a reversible complex that displaces plasminogen from fibrin resulting in inhibition of fibrinolysis. It also inhibits proteolytic activity of plasmin. TXA is frequently used in clinical practice and can be administered via multiple delivery methods, including intravenous, nebulized, and topical. It has been shown to reduce blood loss in a variety of clinical settings without significant adverse effects. It has also been evaluated for prophylactic use with mixed results in reducing bleeding. In our current general pulmonary practic...

Gender

ALL

Eligibility criteria

• Inclusion Criteria:
• • 1. Single or double lung transplant recipients
• • 2. Patients \>18 years old
• • 3. Willingness and ability to sign an informed consent for study participation
• Exclusion Criteria:
• • 1. Platelet count (\<50k/uL)
• • 2. INR (\>1.6)
• • 3. Active bleeding
• • 4. Decompensated liver disease
• • 5. History of uremic bleeding or BUN \>50
• • 6. Severe pulmonary hypertension (mean PA pressure \>40 mmHg on RHC or estimated PA systolic pressure \>62 mmHg on TTE within one year of procedure)
• • 7. Known bleeding disorder
• • 8. Allergy to TXA
• • 9. Prior history of severe TBBx-related airway bleeding requiring admission or advanced maneuvers for hemostasis (examples including intubation, bronchial artery embolization, surgical intervention)
• • 10. Contraindications to topical TXA
• • 11. Pregnancy
• • 12. Vulnerable populations
• • 13. Adults of limited English proficiency/non-English speakers