What were the major findings in the CRASH 2 trial?
Main outcome measures: The primary outcome was death in hospital within 4 weeks of injury, and was described with the following categories: bleeding, vascular occlusion (myocardial infarction, stroke and pulmonary embolism), multiorgan failure, head injury and other.
What is CRASH blood?
Effects of tranexamic acid on death, vascular occlusive events, and blood transfusion in trauma patients with significant haemorrhage (CRASH-2): a randomised, placebo-controlled trial. CRASH-2 trial collaborators. ‡ Author Footnotes. ‡ Members listed at end of paper.
Why is TXA contraindicated in isolated head injury?
All trauma patients with potentially life-threatening bleeding within 3 h of injury should be treated with TXA regardless of blood pressure, GCS or type of injury. Treatment after 3 h appears to increase the risk of death due to bleeding and, therefore, is contraindicated.
Why is tranexamic acid TXA is given to trauma patients?
Tranexamic acid (TXA) reduces blood loss by inhibiting the enzymatic breakdown of fibrin. It is often used in surgery to decrease bleeding and the need for blood transfusion.
What is Crash Trial?
CRASH is a large simple, placebo-controlled trial of the effects of a 48-hour infusion of corticosteroids on death and on neurological disability, among adults with head injury and some impairment of consciousness. Numbered drug or placebo packs will be available in each participating Emergency Department.
What is the crash 3 trial?
The CRASH-3 trial is an international, multicenter, pragmatic, randomized, double-blind, placebo-controlled trial to quantify the effects of the early administration (within 8 h of injury) of TXA on death and disability in TBI patients.
Why do you not give TXA after 3 hours?
After 3 hours, TXA may do more harm than good For those treated with TXA within the first hour of injury, the risk of death due to bleeding was 5.3%, vs 7.7% for the placebo group (RR = 0.68; 95% CI, 0.57-0.82; P<. 0001; NNT = 41).
Does TXA help in DIC?
Because the development of DIC associated with the fibrinolytic phenotype may increase the mortality in trauma, TXA is potentially beneficial to patients who have developed hemostatic abnormalities during the early phase of trauma.
Can tranexamic acid cause death?
Many guidelines, especially those for trauma, focus on the use of tranexamic acid in severely injured patients with a high risk of death from bleeding. 5,6 Although these patients have much to gain from tranexamic acid treatment, they are few in number and many die at the scene.
Why tranexamic acid is contraindicated in DIC?
Tranexamic acid for DIC has dramatic effects on bleeding when used properly with anticoagulant therapy. However, misuse of tranexamic acid can lead to fatal systemic thrombosis, making tranexamic acid a double-edged sword for DIC.