TXA in UGIB

Q: Intravenous (IV) Tranexamic acid can be used as an effective adjuvant therapy in severe upper GI bleeding if it does not resolve appropriately with continuous Proton Pump Inhibitor (PPI) infusion.

A) true

B) False

Answer: B

Although Tranexamic acid is an effective antifibrinolytic agent, it failed to show any efficacy in patients with upper GI bleeds. It should not be used and has no major benefit.

Although there is weak evidence that it may decrease the risk of re-bleeding and the need for surgery, it has no significant effect on the number of blood transfusions or on mortality.

#GI

References:

1. Bennett C, Klingenberg SL, Langholz E, Gluud LL. Tranexamic acid for upper gastrointestinal bleeding. Cochrane Database Syst Rev 2014; :CD006640.

2. HALT-IT Trial Collaborators. Effects of a high-dose 24-h infusion of tranexamic acid on death and thromboembolic events in patients with acute gastrointestinal bleeding (HALT-IT): an international randomised, double-blind, placebo-controlled trial. Lancet 2020; 395:1927.

3. Burke E, Harkins P, Ahmed I. Is There a Role for Tranexamic Acid in Upper GI Bleeding? A Systematic Review and Meta-Analysis. Surg Res Pract. 2021 Jan 29;2021:8876991. doi: 10.1155/2021/8876991. PMID: 33564713; PMCID: PMC7864761.