An underutilized adjuvent treatment in ICU patients who continue to have frequent bouts of hemoptysis is the use of inhaled Tranexamic Acid (TA), an antifibrinolytic agent. This may works well in non-life-threatening hemoptysis. The dose is 500 mg/5 mL every 8 hours for up to five days. It has shown to reduce the volume of hemoptysis, faster resolution and shorter hospital stay. Unfortunately, this may not work in life-threatening hemoptysis, though giving a trial may not be a bad idea when patient is at verge of death.
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References:
1. Wand O, Guber E, Guber A, et al. Inhaled Tranexamic Acid for Hemoptysis Treatment: A Randomized Controlled Trial. Chest 2018; 154:1379.
2. Adams TR, Reeder JA, Alqassab F, Gilbert BW. Inhaled TXA for cases of massive hemoptysis. Am J Emerg Med 2020; 38:156.
3. Dhanani JA, Roberts J, Reade MC. Nebulized Tranexamic Acid Therapy for Hemoptysis Associated with Submassive Pulmonary Embolism. J Aerosol Med Pulm Drug Deliv 2020; 33:12.
4. Segrelles Calvo, Gonzalo et al. Inhaled Tranexamic Acid as an Alternative for Hemoptysis Treatment. CHEST, Volume 149, Issue 2, 604
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