From the Guidelines
Tranexamic acid (TXA) can be effective in stopping an upper gastrointestinal (GI) bleed, with a 40% risk reduction in mortality [ 1 ].
Key Points
- The use of TXA in acute upper GI bleeding has been shown to improve outcomes, although the evidence is not entirely consistent [ 1 ].
- A pooled analysis of several trials demonstrated a significant reduction in mortality with TXA treatment [ 1 ].
- However, when the analysis was limited to trials at low risk of bias, the treatment benefit for mortality was no longer apparent [ 1 ].
- The optimal dosing regimen for TXA in upper GI bleeding is not well established, but it is often administered intravenously [ 1 ].
- TXA may be used as an adjunct to standard endoscopic and supportive care to help stabilize the patient and promote hemostasis in cases of severe upper GI bleeding.
- It is essential to weigh the potential benefits of TXA against the risks of thromboembolic events, although studies have been too small to assess this effect accurately [ 1 ].
- The results of the HALT-IT trial are pending, and until then, the use of TXA in acute upper GI bleeding should be approached with caution [ 1 ].
From the Research
Tranexamic Acid (TXA) and Upper Gastrointestinal (GI) Bleed
- There are no research papers provided that directly address the use of tranexamic acid (TXA) in stopping an upper gastrointestinal (GI) bleed.
- The provided studies focus on the administration of TXA in trauma patients with severe bleeding or at risk of severe bleeding, and its effects on mortality and bleeding-related outcomes 2, 3, 4, 5, 6.
- These studies suggest that TXA can reduce mortality and bleeding in trauma patients when administered promptly, particularly within 1-3 hours of injury 2, 3, 5, 6.
- However, the evidence provided does not specifically relate to the treatment of upper GI bleeds with TXA.