Tranexamic Acid for Antifibrinolysis in Intracerebral Hemorrhage

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Journal name: The Malaysian Journal of Medical Sciences
Original article title: Tranexamic Acid as Antifibrinolytic Agent in Non Traumatic Intracerebral Hemorrhages
The Malaysian Journal of Medical Sciences (MJMS) is a peer-reviewed, open-access journal published online at least six times a year. It covers all aspects of medical sciences and prioritizes high-quality research.
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Original source:

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Author:

Ananda ARUMUGAM, Noor Azman A RAHMAN, Sharon Casilda THEOPHILUS, Ashraf SHARIFFUDIN, Jafri Malin ABDULLAH


The Malaysian Journal of Medical Sciences:

(A peer-reviewed, open-access journal)

Full text available for: Tranexamic Acid as Antifibrinolytic Agent in Non Traumatic Intracerebral Hemorrhages

Year: 2015

Copyright (license): CC BY 4.0


Download the PDF file of the original publication


Summary of article contents:

Introduction

Spontaneous intracerebral hemorrhages (ICH) account for 10-15% of all strokes and represent a significant medical challenge due to high associated mortality and morbidity rates. The current lack of evidence-based treatments for acute ICH highlights an urgent need for effective therapeutic interventions. This study investigates the use of tranexamic acid (TXA), an antifibrinolytic agent, in managing hematoma growth in patients with spontaneous ICH compared to a placebo. Conducted as a single-blinded randomized controlled trial, the research emphasizes strict blood pressure management and the impact of TXA on hematoma volume.

Significant Findings: Effect of Tranexamic Acid

The study revealed crucial findings regarding hematoma expansion in ICH patients. Statistical analysis indicated significant hematoma growth in the control group compared to baseline measurements taken at admission, with a mean size increase from 14.33 cm³ to 17.99 cm³ (P = 0.001). Conversely, the treatment group receiving TXA showed no significant difference in hematoma size from baseline (10.64 cm³) to after 24 hours (10.94 cm³), suggesting that TXA effectively stabilized hematoma volume and mitigated deterioration. These observations highlight the therapeutic potential of TXA in preventing hematoma expansion in acute ICH, warranting further investigation into its clinical efficacy.

Conclusion

In conclusion, the findings from this study strongly advocate for the use of TXA as a promising treatment option in managing spontaneous ICH. By demonstrating that TXA can significantly reduce hematoma volume expansion when used alongside strict blood pressure control, the research provides a vital contribution to the management strategies for ICH. However, the authors emphasize the need for larger multicenter, double-blinded trials to validate these findings and determine optimal treatment protocols before widespread clinical application. Overall, this study serves as a critical step towards improving patient outcomes in ICH management.

FAQ section (important questions/answers):

What is the primary objective of the study on TXA?

The primary objective of the study was to assess the effect of tranexamic acid (TXA) on hematoma growth in patients with spontaneous intracerebral hemorrhage (ICH) compared to a placebo.

How was the study designed and conducted?

The study was a single-blinded, randomized placebo-controlled trial involving intravenous TXA administration followed by strict blood pressure control and a follow-up CT scan after 24 hours to measure hematoma growth.

What were the findings regarding hematoma expansion in the treatment group?

The treatment group showed no significant hematoma size expansion after 24 hours with an average change of 0.02–2.07 cm³, indicating the effectiveness of TXA in stabilizing the hematoma's volume.

What are the recommendations for future research based on this study?

Future research should include larger sample sizes, stricter hypertension management protocols, and the development of new TXA administration protocols for intracerebral hemorrhage patients.

Glossary definitions and references:

Scientific and Ayurvedic Glossary list for “Tranexamic Acid for Antifibrinolysis in Intracerebral Hemorrhage”. This list explains important keywords that occur in this article and links it to the glossary for a better understanding of that concept in the context of Ayurveda and other topics.

1) Table:
Table refers to a structured arrangement of data, often displayed in rows and columns. In research, tables are essential for presenting numerical findings, comparisons, and statistical analyses in a concise manner. They allow for easy access to critical information, enabling readers to comprehend results quickly.

2) Study (Studying):
A study is a systematic investigation aimed at discovering or confirming knowledge about specific subjects. In medical research, studies are vital for testing hypotheses, evaluating interventions, and enhancing understanding of diseases. They provide evidence-based conclusions that inform clinical practices and guidelines.

3) Blood:
Blood is a vital fluid that circulates in the body's vessels, transporting nutrients, gases, and waste. In medical research, blood parameters are crucial indicators of health and disease. Understanding blood composition and behavior is essential for diagnosing conditions, monitoring treatments, and researching diseases' pathophysiology.

4) Rules:
Rules in a medical context often refer to guidelines or protocols that govern clinical practices and research methodologies. They ensure consistency, ethical considerations, and safety in patient care and studies. Adhering to established rules helps maintain the integrity of research findings and improves patient outcomes.

5) Drug:
A drug is a substance intended for use in the diagnosis, cure, treatment, or prevention of disease. In clinical trials, drugs like tranexamic acid (TXA) are assessed for their efficacy and safety. Understanding drug interactions, side effects, and pharmacodynamics is crucial for effective healthcare.

6) Death:
Death is the irreversible cessation of biological functions that sustain a living organism. In medical studies, mortality rates often serve as critical endpoints, helping assess the efficacy of treatments. Understanding factors that influence death can improve patient care and guide public health interventions.

7) Nausea:
Nausea is a sensation of unease and discomfort in the stomach, often accompanied by an urge to vomit. It serves as a common symptom in various medical conditions and can result from medications, infections, or metabolic abnormalities. Understanding its causes is important for effective symptom management.

8) Pharmacology:
Pharmacology is the study of drugs, their properties, effects, mechanisms of action, and therapeutic uses. This field is essential for understanding how medications work within the body, guiding the development of treatment protocols, and ensuring the safe and effective use of pharmacological agents in various conditions.

9) Accumulation (Accumulating, Accumulate):
Accumulation refers to the gradual increase or buildup of substances in the body over time. In the context of diseases, it can relate to the storage of toxins, medications, or metabolic byproducts. Understanding accumulation processes assists in diagnosing conditions and managing treatments effectively.

10) Calculation:
Calculation is the process of determining numerical values based on mathematical methods or formulas. In medical research, calculations might involve statistical analyses of patient data, dosages of medications, or assessments of risk factors. Accurate calculations are critical for ensuring valid results and appropriate clinical decisions.

11) Observation:
Observation refers to the act of monitoring and recording subject behavior, events, or symptoms over time. In clinical settings, observational studies provide valuable insights into disease progression, treatment effects, and patient responses, which can inform clinical guidelines and improve healthcare quality.

12) Vomiting:
Vomiting is the expulsion of stomach contents through the mouth. It can indicate various medical conditions and may result from side effects of drugs or infections. Understanding the causes and management of vomiting is vital for patient comfort and care, particularly in acute situations.

13) Bleeding:
Bleeding involves the loss of blood from the circulatory system, which can be a critical condition in medical emergencies. It may result from injuries, surgeries, or medical disorders. Managing bleeding is crucial in treating various conditions and preventing severe health consequences, including death.

14) Quality:
Quality in healthcare refers to the standard of services provided to patients, encompassing aspects like safety, efficiency, and satisfaction. Assessing quality is vital for improving clinical practices, ensuring adherence to medical guidelines, and enhancing patient outcomes. Continuous quality improvement initiatives are essential in health systems.

15) Disease:
Disease is a pathological condition resulting from various factors, including infections, genetic mutations, and environmental influences. Understanding diseases, their mechanisms, and treatment options is fundamental to medical practice. Research into diseases informs the development of effective therapies and preventive measures to improve public health.

16) Account:
Account refers to a detailed report or description of an event or situation. In research, accounts can encompass patient histories, treatment outcomes, and observations. They provide essential context for understanding healthcare phenomena and evaluating the effectiveness of interventions and studies.

17) Family:
Family generally refers to a group of individuals related by blood, marriage, or social ties. In healthcare contexts, understanding family dynamics is crucial for holistic patient care, as family members often play key roles in support, caregiving, and decision-making regarding treatment plans.

18) Indian:
Indian refers to a person from India or of Indian descent. In medical research, ethnicity can impact health outcomes, risk factors, and responses to treatments. Understanding diverse populations, including Indian communities, is essential for tailoring healthcare approaches and addressing health disparities effectively.

19) Bharu:
Bharu refers to Johor Bharu, a city in Malaysia often relevant in discussions about local healthcare practices, study settings, and patient demographics. Understanding the geography and sociodemographics of such locations enriches the context for medical research and policy-making at the regional level.

20) Jaya:
Jaya, often associated with names of places or organizations in Malaysia, signifies 'victory' or 'success' in Malay. While not a primary medical term, its significance may arise in discussions regarding health initiatives or successful outcomes in healthcare practices, fostering community engagement and support.

21) Sign:
Sign in medical contexts refers to objective evidence of disease observable during examinations. Identifying signs is vital in clinical diagnostics as they guide healthcare professionals in understanding disease severity, making informed decisions, and formulating appropriate treatment plans based on observable phenomena.

22) Qian:
Qian is a common Chinese surname. In the context of medical research, familial and cultural backgrounds can influence health behaviors, treatment responses, and outcomes. Understanding the role of cultural differences is crucial for providing personalized healthcare and fostering effective patient-provider communication.

23) Pur:
Poor refers to suboptimal health status, access to resources, or lower socioeconomic conditions. In medical research, socio-economic factors significantly influence health outcomes and access to treatment. Addressing disparities in healthcare access and quality is essential for improving overall population health and equity.

24) Male:
Male refers to the gender classification associated with biological traits and reproductive functions related to masculinity. In medical studies, understanding gender differences is crucial, as they can impact disease prevalence, symptoms, treatment responses, and overall health outcomes, leading to more tailored healthcare approaches.

25) Chan:
Chan is a common Chinese surname that represents diverse cultural backgrounds. In discussions about health research, understanding cultural identity, including health-seeking behaviors and attitudes, is important for designing effective interventions and ensuring culturally competent care within various populations.

26) Measurement:
Measurement refers to the quantification of health parameters, symptoms, or outcomes in research. Accurate measurement is key in clinical trials, allowing for valid comparisons and analyses. Without precise measurements, conclusions may be flawed, impacting the reliability and applicability of research findings.

27) Discussion:
Discussion in research refers to the section where study results are analyzed, interpreted, and compared with existing literature. It provides a platform for researchers to explore the implications of their findings, highlight limitations, and suggest future directions for study, thus contributing to advancing knowledge.

28) Pregnant:
Pregnant refers to the condition of carrying a developing fetus within the womb. Understanding pregnancy is crucial in medical and pharmacological contexts, as many conditions and treatments can uniquely affect pregnant individuals. Focusing on maternal-fetal health improves outcomes for both mother and child.

29) Fever:
Fever is a temporary increase in body temperature often due to an illness. It serves as a common sign of infection or inflammation. Understanding the underlying causes of fever is essential for diagnosis and treatment, guiding healthcare professionals in their approach to patient care.

30) Post:
Post refers to events or conditions that occur after a specific point, often following treatment or intervention. In medical research, post-treatment assessments are critical for evaluating the effectiveness of therapies, monitoring recovery progress, and making informed decisions regarding ongoing care and interventions.

31) Coma:
Coma is a prolonged state of unresponsiveness resulting from severe brain injury or other medical conditions. Understanding coma's causes and potential outcomes is vital for medical professionals. Research into coma and related states informs treatment strategies and helps guide family discussions regarding prognosis and care.

Other Science Concepts:

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Discover the significance of concepts within the article: ‘Tranexamic Acid for Antifibrinolysis in Intracerebral Hemorrhage’. Further sources in the context of Science might help you critically compare this page with similair documents:

Surgical intervention, Adverse effect, Supportive care, Future research, Blood-pressure, Statistical analysis, Control group, Patient, Inclusion criteria, Exclusion criteria, Treatment group, Sample size, Study population, Ischemic Stroke, Female patient, Stroke, Sample size calculation, Blood parameters, Hypertension treatment, Ethical approval, Phase II trial, Interquartile Range, Computed tomography, Haemorrhagic Stroke, Intracerebral hemorrhage, Normal range, Blood pressure control, Maintenance dose, Tranexamic acid, Adverse event, Patient demographic, Blood clot, Randomised controlled trial, Brain CT scan, Volume expansion, Brain CT, Male patient, Neurological deterioration, Computed tomography brain, Long-term outcome, Fibrin network, Authors contribution, Significant Risk Factor, Lysine, Antifibrinolytic agent.

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