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Tranexamic Acid to reduce surgical bleeding
NHS Blood and Transplant issued an 'amber alert' on 12th of October, meaning hospitals have been asked to put in place management plans to protect blood stocks. In line with these measures requested by NHSBT, we recommend that use of tranexamic acid is considered in all adult surgical patients and administered if more than 500ml of blood loss is likely. We also recommend that theatre teams consider adding this prompt to the perioperative care theatre checklist process.

 

THE USE OF TRANEXAMIC ACID- USEFUL RESOURCES

NHS Blood and Transplant issued an 'amber alert' on 12th of October, meaning hospitals  have been asked to put in place management plans to protect blood stocks. In line with these measures requested by NHSBT, we recommend that use of tranexamic acid is considered in all adult surgical patients and administered if more than 500ml of blood loss is likely. We also recommend that theatre teams consider adding this prompt to the perioperative care theatre checklist process. 

Results from the recent POISE-3 clinical trial confirm the quality, safety and cost-effectiveness of using tranexamic acid in moderate surgery, where more than 500ml of blood loss is anticipated. This evidence further supports the NICE quality statement on blood transfusion and complements the recent Centre for Perioperative Care guideline 'Anaemia in the Perioperative Pathway'

Increasing the use of tranexamic acid in this way may reduce the risk of cancelling elective surgery due to limited availability of blood stocks.

Please share this with your colleagues, especially those in your perioperative, surgical and anaesthetic departments.

Join the RCSEng Webinar (link here) at 6pm on 21 November to hear Professor Neil Mortensen, President of RCS England, and other leading surgeons share important information about the use of Tranexamic acid. The webinar will feature a live Q&A.

Here are some useful resources to read more about the use of tranexamic acid:

Who invented tranexamic acid?

 

https://txacentral.lshtm.ac.uk/celebrating-women-in-science/

https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(19)31155-9/fulltext

https://www.youtube.com/watch?v=VbDDxzyp1rQ

 

How does tranexamic acid work?

https://www.youtube.com/watch?v=emAHFC-Aidg

 

Does tranexamic acid reduce surgical bleeding?

https://www.nejm.org/doi/full/10.1056/nejmoa1606424

https://www.nejm.org/doi/full/10.1056/NEJMoa2201171

 

Is tranexamic acid safe? 

https://jamanetwork.com/journals/jamasurgery/fullarticle/2778639

https://pubmed.ncbi.nlm.nih.gov/34724964/

 

What does the Joint Royal Colleges Tranexamic acid in Surgery Implementation Group think?

https://www.rcseng.ac.uk/news-and-events/news/archive/tranexamic-acid-to-reduce-surgical-bleeding/

https://www.sciencedirect.com/science/article/pii/S0007091222003440?via%3Dihub

 

What about tranexamic acid in bleeding trauma patients?

https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(10)60835-5/fulltext

https://www.youtube.com/watch?v=pIoYJUf1uls

https://ctu.lshtm.ac.uk/crash-2-results/

 

What about tranexamic acid in post-partum bleeding?

https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(17)30638-4/fulltext

https://ctu.lshtm.ac.uk/woman-trial-results/

 

Where can I find out more and ask questions?

https://register.gotowebinar.com/register/4743448619774418699

 

 

BBraun
CMR Surgical
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