Evidence map›Paper›PMID 28601210›Full record

SynthesisWilderness & environmental medicine2017

Tranexamic Acid Use in Prehospital Uncontrolled Hemorrhage.

Benjamin R Huebner, Warren C Dorlac, Chris Cribari

Registry-linked trialAbstract readSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Wilderness & environmental medicine, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03846973 (Evaluation of the Safety and Efficacy of the Second Dose of Tranexamic Acid Administration of Trauma Patients), which is not on this map. Cited by 17 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
17citing papers in PubMed, 3 pooled it
3.9field-weighted citation impact, top 6% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT03846973 phase3completednot on this mapstarted 2018, after this paper: background citation

Evaluation of the Safety and Efficacy of the Second Dose of Tranexamic Acid Administration of Trauma Patients: A Randomized, Double-blind Controlled Clinical Trial

TypeinterventionalSponsorHamad Medical CorporationRan2018 to 2021Enrolled220ConditionsTranexamic AcidArmsTranexamic Acid, Placebo
3 · Its place in the literature

Who cites it

17 citing papers in PubMed, 3 syntheses or guidelines pooled it, 47 citations in OpenAlex.

  1. Pooled it
  2. Systemic hemostatic agents initiated in trauma patients in the pre-hospital setting: a systematic review.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2023
    Pooled it
  3. Pooled it
  4. Trial
  5. Review
  6. Review
  7. Rethinking Balanced Resuscitation in Trauma.Journal of clinical medicine · 2025
    Review
  8. Review
  9. Article
  10. Review
  11. Review
  12. Observational
  13. Article
  14. Article
  15. Review
  16. Review
  17. Fibrinolysis in trauma: a review.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2018
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

3 authors at 2 institutions in 1 country.

Benjamin R HuebnerDepartment of Surgery, University of Cincinnati, Cincinnati, OH (Dr Huebner).
Warren C DorlacUniversity of Colorado Health, Loveland, CO and Volunteer Clinical Faculty, Department of Surgery, University of Cincinnati, Cincinnati, OH (Dr Dorlac). Electronic address: Warren.dorlac@uchealth.org.
Chris CribariUniversity of Colorado Health, Loveland, CO (Dr Cribari).
University of Cincinnati · USUniversity of Colorado Health · US

Funding

Mechanisms of Trauma-Induced CoagulopathyT32GM008315 · NIGMS · UNIVERSITY OF COLORADO DENVER · PI Mitchell Cohen, ELIZABETH J. KOVACS · 1991 to 2026
$7.1M
NIGMS NIH HHS T32 GM008315
6 · The paper itself

Abstract

The use of tranexamic acid (TXA) in the treatment of trauma patients was relatively unexplored until the landmark Clinical Randomisation of an Antifibrinolytic in Significant Haemorrhage-2 (CRASH-2) trial in 2010 demonstrated a reduction in mortality with the use of TXA. Although this trial was a randomized, double-blinded, placebo-controlled study incorporating >20,000 patients, numerous limitations and weaknesses have been described. As a result, additional studies have followed, delineating the potential risks and benefits of TXA administration. A systematic review of the literature to date reveals a mortality benefit of early (ideally <1 hour and no later than 3 hours after injury) TXA administration in the treatment of severely injured trauma patients (systolic blood pressure <90 mm Hg, heart rate >110). Combined with abundant literature showing a reduction in bleeding in elective surgery, the most significant benefit may be administration of TXA before the patient goes into shock. Those trials that failed to show a mortality benefit of TXA in the treatment of hemorrhagic shock acknowledged that most patients received blood products before TXA administration, thus confounding the results. Although the use of prehospital TXA in the severely injured trauma patient will become more clear with the trauma studies currently underway, the current literature supports the use of prehospital TXA in this high-risk population. We recommend considering a 1 g TXA bolus en route to definitive care in high-risk patients and withholding subsequent doses until hyperfibrinolysis is confirmed by thromboelastography.

Indexed as

Antifibrinolytic AgentsHemorrhageHumansTranexamic AcidAntifibrinolytic AgentsTranexamic Acidbleedingcoagulopathyhemorrhagic shockhyperfibrinolysistranexamic acidtrauma

Identifiers

PMID28601210
PMCPMC5567779
OpenAlexW2624237577

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.