Back to Search
Start Over
Inhaled Tranexamic Acid for Hemoptysis Treatment: A Randomized Controlled Trial.
- Source :
-
Chest [Chest] 2018 Dec; Vol. 154 (6), pp. 1379-1384. Date of Electronic Publication: 2018 Oct 12. - Publication Year :
- 2018
-
Abstract
- Background: Tranexamic acid (TA) is an antifibrinolytic drug currently used systemically to control bleeding. To date, there have been no prospective studies of the effectiveness of inhaled TA for the treatment of hemoptysis.<br />Objectives: The goal of this study was to prospectively assess the effectiveness of TA inhalations (ie, nebulized TA) for hemoptysis treatment.<br />Methods: This analysis was a double-blind, randomized controlled trial of treatment with nebulized TA (500 mg tid) vs placebo (normal saline) in patients admitted with hemoptysis of various etiologies. Patients with massive hemoptysis (expectorated blood > 200 mL/24 h) and hemodynamic or respiratory instability were excluded. Mortality and hemoptysis recurrence rate were assessed at 30 days and following 1 year.<br />Results: Forty-seven patients were randomized to receive TA inhalations (n = 25) or normal saline (n = 22). TA was associated with a significantly reduced expectorated blood volume starting from day 2 of admission. Resolution of hemoptysis within 5 days of admission was observed in more TA-treated patients than in those receiving placebo (96% vs 50%; P < .0005). Mean hospital length of stay was shorter for the TA group (5.7 ± 2.5 days vs 7.8 ± 4.6 days; P = .046), with fewer patients requiring invasive procedures such as interventional bronchoscopy or angiographic embolization to control the bleeding (0% vs 18.2%; P = .041). No side effects were noted in either group throughout the follow-up period. In addition, a reduced recurrence rate was noted at the 1-year follow-up (P = .009).<br />Conclusions: TA inhalations can be used safely and effectively to control bleeding in patients with nonmassive hemoptysis.<br />Trial Registry: ClinicalTrials.gov; No.: NCT01496196; URL: www.clinicaltrials.gov.<br /> (Copyright © 2018 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.)
- Subjects :
- Adult
Antifibrinolytic Agents administration & dosage
Antifibrinolytic Agents adverse effects
Double-Blind Method
Drug Monitoring methods
Female
Hospitalization statistics & numerical data
Humans
Male
Middle Aged
Recurrence
Severity of Illness Index
Treatment Outcome
Administration, Inhalation
Hemoptysis diagnosis
Hemoptysis drug therapy
Hemoptysis mortality
Tranexamic Acid administration & dosage
Tranexamic Acid adverse effects
Subjects
Details
- Language :
- English
- ISSN :
- 1931-3543
- Volume :
- 154
- Issue :
- 6
- Database :
- MEDLINE
- Journal :
- Chest
- Publication Type :
- Academic Journal
- Accession number :
- 30321510
- Full Text :
- https://doi.org/10.1016/j.chest.2018.09.026