Antifibrinolytics in the treatment of traumatic brain injury.
Curr Opin Anaesthesiol
; 35(5): 583-592, 2022 Oct 01.
Article
en En
| MEDLINE
| ID: mdl-35900731
ABSTRACT
PURPOSE OF REVIEW Traumatic brain injury (TBI) is a leading cause of trauma-related deaths, and pharmacologic interventions to limit intracranial bleeding should improve outcomes. Tranexamic acid reduces mortality in injured patients with major systemic bleeding, but the effects of antifibrinolytic drugs on outcomes after TBI are less clear. We therefore summarize recent evidence to guide clinicians on when (not) to use antifibrinolytic drugs in TBI patients. RECENT FINDINGS:
Tranexamic acid is the only antifibrinolytic drug that has been studied in patients with TBI. Several recent studies failed to conclusively demonstrate a benefit on survival or neurologic outcome. A large trial with more than 12â000 patients found no significant effect of tranexamic acid on head-injury related death, all-cause mortality or disability across the overall study population, but observed benefit in patients with mild to moderate TBI. Observational evidence signals potential harm in patients with isolated severe TBI.SUMMARY:
Given that the effect of tranexamic acid likely depends on a variety of factors, it is unlikely that a 'one size fits all' approach of administering antifibrinolytics to all patients will be helpful. Tranexamic acid should be strongly considered in patients with mild to moderate TBI and should be avoided in isolated severe TBI.
Texto completo:
1
Banco de datos:
MEDLINE
Asunto principal:
Ácido Tranexámico
/
Lesiones Traumáticas del Encéfalo
/
Antifibrinolíticos
Tipo de estudio:
Etiology_studies
Límite:
Humans
Idioma:
En
Revista:
Curr Opin Anaesthesiol
Asunto de la revista:
ANESTESIOLOGIA
Año:
2022
Tipo del documento:
Article
País de afiliación:
Países Bajos