In Practice

Antifibrinolytic drugs for acute traumatic injury

Michael McCaul, Tamara Kredo


In South Africa, trauma is a major concern, with violence and road traffic accidents being the fifth and seventh leading causes of death, respectively. Antifibrinolytic agents have been used in trauma and major surgery to prevent fibrinolysis and reduce blood loss. We highlight an updated Cochrane review investigating the effect of antifibrinolytic drugs in patients with acute traumatic injury. The review authors
conducted comprehensive literature searches in January 2015 with regard to all randomised controlled trials comparing antifibrinolytic agents after acute traumatic injury. Three randomised controlled trials, of which two (n=20 451) assessed the effect of tranexamic acid (TXA), were included. The authors concluded that TXA safely reduces mortality in trauma with bleeding without increasing the risk of
adverse events. TXA should be administered as early as possible, and within 3 hours of injury. There is still uncertainty with regard to the effect of TXA on patients with traumatic brain injury; however, ongoing randomised controlled trials should shed more light on this.

Authors' affiliations

Michael McCaul, Centre for Evidence-Based Health Care, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa

Tamara Kredo, Cochrane South Africa, South African Medical Research Council, Cape Town, South Africa

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Review; Trauma; Antifibrinolytic

Cite this article

South African Medical Journal 2016;106(8):777-778. DOI:10.7196/SAMJ.2016.v106i8.11042

Article History

Date submitted: 2016-05-13
Date published: 2016-07-13

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