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A colleague asks what people are doing in regards to the antifibrinolytic TXA use in patients with DIC who are massively hemorrhaging. George has found a number of articles describing the efficacy of tranexamic acid and epsilon-amino-caproic acid in treating post-partum hemorrhage, which is close, but nothing directly recording TXA in DIC. If you have experienc with this, please reply below. Thank you.

Comments (1)
Oct 26, 2017 4:17pm

According to British
According to British guidelines of 2009: “…patients with DIC should not be treated with antifibrinolytic agents. Patients with DIC that is characterised by a primary hyperfibrinolytic state and who present with severe bleeding could be treated with lysine analogues, such as tranexamic acid (e.g. 1 g every 8 h)…”

Levi M, Toh CH, Thachil J, Watson HG. Guidelines for the diagnosis and management of disseminated intravascular coagulation.
British Committee for Standards in Haematology. Br J Haematol. 2009;145:24–33.

As an example for successful application of TXA in this type of DIC: Prokopchuk-Gauk O, Brose K. Tranexamic acid to treat life-threatening hemorrhage in prostate cancer associated disseminated intravascular coagulation with excessive fibrinolysis. Cureus. 2015;22;7:e428.

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