So an incredibly important paper, CRASH-3 has just been published in the Lancet, which looks at the treatment of head injuries with Tranexamic Acid (TXA).
TXA has been shown to save lives in trauma patients at the risk of major haemorrhage, with the notable exclusion of those with head injuries, CRASH-2. TXA has been shown to save lives in those with post parts haemorrhage, WOMAN trial. Time to treatment with TXA has been shown to be hugely influential in it's ability to decrease blood loss and save lives. So has TXA now been shown to save lives in head injuries?
In this episode we run through the paper and are lucky enough to have an interview with the lead author, Professor Ian Roberts.
Have a listen, read the paper and as always we’d love to hear any thoughts or comments you have on the website and via twitter, and take a look at the references below to draw your own conclusions.
Simon, Rob & James
The CRASH-2 trial: a randomised controlled trial and economic evaluation of the effects of tranexamic acid on death, vascular occlusive events and transfusion requirement in bleeding trauma patients.Roberts I. Health Technol Assess. 2013
CRASH-2;The Bottom Line
Effectof earlytranexamic acidadministrationon mortality, hysterectomy, and othermorbiditiesin womenwith post-partum haemorrhage(WOMAN): an international, randomised, double-blind, placebo-controlledtrial. WOMANTrialCollaborators.Lancet 2017
WOMAN Trial;The Bottom Line
Effect of treatment delay on the effectiveness and safety of antifibrinolytics in acute severe haemorrhage: a meta-analysis of individual patient-level data from 40 138 bleeding patients.Gayet-Ageron A. Lancet. 2017
Tranexamic Acid - The Mechanism of Action;Video
Tranexamic Acid, Time to Treatment;The Resus Room
Does earlier TXA save lives?St Emlyns
TXA podcast; PHEMCAST
About CRASH-3; LSHTM