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Stemming the flow: nebulised transexamic acid can be used to control bleeding in patients with non-massive haemoptysis
Transexamic acid (TA) is an antifibrinolytic drug used to control bleeding and is most commonly administered as a systemic preparation. The effectiveness of nebulised TA in the treatment of haemodynamically stable patients with non-massive haemoptysis was assessed in a prospective, double-blind, randomised controlled trial of nebulised TA (500 mg, three times per day) versus 0.9% 5 mL normal saline (Wand et al, Chest 2018; doi: 10.1016/j.chest.2018.09.026). Forty-seven patients were randomised; 25 patients received nebulised TA and 22 patients received the normal saline placebo. Resolution of bleeding was achieved within 5 days from admission in 96% of the TA-treated group and 50% of the placebo group (p<0.0005). Mean hospital length of stay was shorter for the TA group compared with the placebo group (5.7±2.5 versus 7.8±4.6 days, p=0.046). Four out of 22 patients in the placebo group and none out of 25 patients in the TA group required interventional procedures to control bleeding (p=0.041). There were no serious adverse events reported in …
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