The effect of early tranexamic acid on bleeding, blood product consumption, mortality and length of hospital stay in trauma cases with hemorrhagic shock: a randomized clinical trial.

Introduction: Because no medication has been approved for coagulation support in trauma, the current study was aimed to evaluate the effectiveness of intravenous injection of Tranexamic acid (TXA) in patients with acute traumatic bleeding. Methods: In the current randomized controlled clinical trial, 68 patients with acute bleeding and hemorrhagic shock presentation due to blunt trauma of the abdomen, pelvis, and thorax, randomly assigned into two groups of TXA and placebo. Results: There was no statistically significant difference between the two groups in terms of Systolic blood pressure, pulse rate, Base excess, serum hemoglobin changes, bleeding volume, the incidence of thrombotic events, and the number of deaths (p > 0.05). But Systolic blood pressure, pulse rate, base excess, and serum hemoglobin, changed significantly within each group over time(p < 0.05). The median time for the length of hospital stay among the TXA group was lower than the Placebo group (6 days vs 10 days, p = 0.004). Also, there was a significant difference between the two groups about the median of pack cell, Platelet consumption, and bleeding Volume (p < 0.05). Conclusion: The use of TXA is associated with lower use of blood production and reduced length of hospital stay, however, thrombotic events incidence and mortality rates between the TXA and placebo groups were not different.