ArticleThe Laryngoscope2026
Clinical Care Guideline Implementation of Nebulized Tranexamic Acid in Post-Tonsillectomy Hemorrhage.
Article in The Laryngoscope, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
What it found
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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.
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Who cites it
2 citing papers in PubMed.
- Clinical Care Guideline Implementation of Nebulized Tranexamic Acid in Post-Tonsillectomy Hemorrhage.The Laryngoscope · 2026Article
- Is Tranexamic Acid Safe and Effective for Treatment of Pediatric Postoperative Tonsillectomy Bleeds?The Laryngoscope · 2026Article
Corrections and comments
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesNebulized tranexamic acid (TXA) can be utilized for non-operative management in post-tonsillectomy hemorrhage (PTH). Rapid adoption of new treatments in hospital settings is challenging due to personnel turnover, formulary restrictions, and inconsistent awareness. We investigated the utility of clinical care guideline (CCG) implementation on adherence to a TXA protocol and its association with operative control of hemorrhage.
methodsModel for Improvement methodology was utilized to develop CCG for TXA administration. An algorithm was created where patients presenting to the Emergency Department (ED) with active bleeding or blood clot received three nebulized TXA treatments. Exclusion criteria were severe bleeding, absence of active bleeding or clot, and inability to tolerate treatment or protect the airway. An order set was used to facilitate implementation. Data from 2 years pre- and post-initiation were compared. Measures included ED returns for PTH, TXA order set usage, TXA administration frequency, returns to the operating room, and secondary returns to the ED.
resultsThere were 2805 and 5382 tonsillectomies pre- and post- implementation periods respectively. There was no difference in patient age in the two groups. ED returns for bleeding were 70 (2.5%) and 155 (2.9%) respectively (p > 0.05). Post-implementation, 126 patients met inclusion criteria for TXA (81.3%). Order set utilization of patients receiving TXA in the ED was 95.7%. Operative PTH management pre- and post-intervention was 35/70 (50%) and 42/155 (27.1%) respectively (p = 0.001, ARR 0.320, 95% CI 0.116-0.500).
conclusionsImplementation of a PTH clinical care guideline was associated with rapid adoption of TXA adherence. This was associated with reduced rates of OR returns. LEVEL OF EVIDENCE: 3:
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