Use of Atomized Intranasal Tranexamic Acid as an Adjunctive therapy in Difficult-to-Treat Epistaxis
Sarkar, D.; Martinez, J.
Journal of Special Operations Medicine a Peer Reviewed Journal for Sof Medical Professionals 19(2): 23-28
2019
ISSN/ISBN: 1553-9768 PMID: 30859538 Document Number: 698757
There is a growing body of literature on the safe, effective use of tranexamic acid (TXA) for hemostasis in a variety of clinical settings. We present a case series of three patients with difficult-to-treat epistaxis where standard treatment methods were not effective. Using atomized intranasal TXA (ATXA) as part of a stepwise treatment approach, we were able to achieve hemostasis and manage all three cases independently, and we did so without major complications in our emergency department (ED). Given recent literature showing the underuse of TXA in combat casualties, ATXA, if formulated and delivered properly, may be of benefit for epistaxis and other significant hemorrhage cases. Further work must be done to elucidate the mechanism of action, specific dose, delivery method, use indications, and safety profile of ATXA.