Topical application of tranexamic acid for the reduction of bleeding

Topical application of tranexamic acid appears to reduce bleeding in surgical patients.

The quality of evidence is downgraded by inconsistency (unexplained variability in results).

Summary

A Cochrane review included 29 studies with a total of 2 612 subjects. Twenty-eight studies involved patients undergoing surgery and one study involved patients with epistaxis. Tranexamic acid (TXA) reduced blood loss by 29% (pooled ratio 0.71, 95% CI 0.69 to 0.72; statistical heterogeneity I²=91%; 18 studies, n= 1 651). There was uncertainty regarding the effect on death (RR 0.28, 95% CI 0.06 to 1.34; 9 studies, n=894), myocardial infarction (RR 0.33, 95% CI 0.04 to 3.08; 6 studies, n= 362), stroke (RR 0.33, 95% CI 0.01 to 7.96; 5 studies, n= 441), deep vein thrombosis (RR 0.69, 95% CI 0.31 to 1.57; 9 studies, n=789) and pulmonary embolism (RR 0.52, 95% CI 0.09 to 3.15; 8 studies, n= 741). TXA reduced the risk of receiving a blood transfusion by a relative 45% (RR 0.55, 95% CI 0.46 to 0.65; statistical heterogeneity I²=76%; 15 studies, n= 1 623).

Clinical comments

Date of latest search:

Ədəbiyyat

1. Ker K, Beecher D, Roberts I. Topical application of tranexamic acid for the reduction of bleeding. Cochrane Database Syst Rev 2013;(7):CD010562.