Details

Autor(en) / Beteiligte

• Mitra, Biswadev
• Fitzgerald, Mark
• Cameron, Peter A
• Gruen, Russell L
• Casati, Valter
• Romano, Angelo
• Novelli, Eugenio
• D'Angelo, Armando
• Yeguiayan, Jean-Michel
• Rosencher, Nadia
• Freysz, Marc
• Shakur, Haleema
• Roberts, Ian
• Perel, Pablo

Titel

Tranexamic acid for trauma/Authors' reply

Ist Teil von

• The Lancet (British edition), 2010-09, Vol.376 (9746), p.1049

Ort / Verlag

London: Elsevier Limited

Erscheinungsjahr

2010

Quelle

Access via ScienceDirect (Elsevier)

Beschreibungen/Notizen

• In our patients, occurrence of convulsive seizures (0.3%) was at least ten-fold less frequent than seen with high-dose tranexamic acid.3 Neurological complications in cardiac surgery are relatively frequent; causes are multifactorial, including cerebral hypoperfusion, systemic inflammation induced by extracorporeal circulation and surgical trauma, cerebral oedema with blood-brain barrier dysfunction, and alterations in cerebral temperature regulation. All the above factors can also be seen in patients with severe trauma. [...] given that inhibition of fibrinolysis is obtained with low doses of tranexamic acid and that low and high doses of tranexamic acid reduce bleeding to a very similar extent, we agree with Jerrold Levy's words of caution.2 We declare that we have no conflicts of interest. *Valter Casati, Angelo Romano, Eugenio Novelli, Armando D'Angelo valter.casati@policlinicodimonza.it Division of Cardiovascular Anaesthesia and Intensive Care, Clinica S Gaudenzio, 28100 Novara, Italy (VC, AR, EN); and Scientific Institute H S Raff aele, Milan, Italy (ADA) 1 CRASH-2 trial collaborators.