Topical Application of Tranexamic Acid for the Reduction of Bleeding

Summary

A Cochrane review [Abstract] 1 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).