Understanding the TXA seizure connection
The Journal of clinical investigation (Impact Factor: 13.22). 11/2012; 122(12). DOI: 10.1172/JCI66724
Transexamic acid (TXA) is an antifibrinolytic that has been used successfully to prevent blood loss during major surgery. However, as its usage has increased, there have been growing reports of postsurgical seizure events in cardiac surgery patients. In this issue of the JCI, Lecker et al. explore this connection and suggest that TXA-mediated inhibition of glycine receptors may underlie the effect. This finding prompted the authors to explore the preclinical efficacy of common anesthetics that function by reducing the TXA-mediated inhibition to prevent or modify postsurgical seizures.
- 06/2013; 74(6):1575-1586. DOI:10.1097/TA.0b013e318292cc54
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ABSTRACT: Bleeding is the second leading cause of death after trauma. Initial care of the patient with hemorrhage focuses on restoring circulating blood volume and reversing coagulopathy. Trauma and injury can initiate the coagulation cascade. Patients with massive bleeding should be resuscitated with goal-directed therapy. Hemostatic resuscitation in conjunction with ratio-based transfusion and massive transfusion protocols should be utilized while awaiting hemorrhage control. The military initiated massive transfusion protocols in the battlefield. We discuss the coagulation cascade, recent recommendations of goal-directed therapy, massive transfusion protocols, fixed ratios, and the future of transfusion medicine. Copyright © 2014 Elsevier Inc. All rights reserved.Emergency Medicine Clinics of North America 08/2014; 32(4). DOI:10.1016/j.emc.2014.07.005 · 0.78 Impact Factor
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