TANICH II: 3g Tranexamic Acid's Role in Hematoma Reduction

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Journal name: The Malaysian Journal of Medical Sciences
Original article title: Tranexamic Acid in Non-Traumatic Intracerebral Haemorrhage (TANICH II): Introducing the Potential Role of 3 g Tranexamic Acid in Haematoma Reduction
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, Shze Ee Tan, Sze Ling Tan, Jun Ee Tan, Fatimah @ Hartina Hussin, Mohd Sofan Zenian, Zamzuri Idris, Jafri Malin Abdullah


The Malaysian Journal of Medical Sciences:

(A peer-reviewed, open-access journal)

Full text available for: Tranexamic Acid in Non-Traumatic Intracerebral Haemorrhage (TANICH II): Introducing the Potential Role of 3 g Tranexamic Acid in Haematoma Reduction

Year: 2023 | Doi: 10.21315/mjms2023.30.3.8

Copyright (license): CC BY 4.0


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Summary of article contents:

Introduction

Intracerebral hemorrhage (ICH) is a significant medical condition that leads to high rates of mortality and morbidity. The expansion of a hematoma after acute ICH can exacerbate neurological deterioration and negatively affect clinical outcomes. Current studies are exploring the potential of tranexamic acid (TXA), an anti-fibrinolytic agent, as a treatment to reduce hematoma expansion, although the optimal dosage is not yet established. This study aimed to evaluate the effectiveness of different doses of TXA in managing non-traumatic ICH.

Efficacy of Tranexamic Acid

The trial was a double-blinded, randomized, placebo-controlled study involving 60 adult patients diagnosed with hypertensive ICH. Participants were assigned to receive either a placebo, a 2-gram dose of TXA, or a 3-gram dose of TXA. Although the results revealed no statistically significant difference in mean changes of hematoma volume among the three groups, the group receiving 3 grams of TXA showed a reduction in hematoma volume, contrasting with expansions observed in the placebo and 2-gram groups. Moreover, good recovery was noted across all groups, with no adverse effects reported.

Conclusion

This study represents the first clinical evaluation of a 3-gram TXA dosage in the treatment of non-traumatic ICH. While it suggests that a higher dose of TXA may aid in reducing hematoma volume without adverse reactions, the findings warrant further investigation. Larger-scale randomized controlled trials are necessary to confirm these observations and determine the safety and efficacy of TXA at this dosage for patients experiencing non-traumatic ICH.

FAQ section (important questions/answers):

What is the purpose of this study on tranexamic acid?

The study aims to investigate the efficacy of different doses of tranexamic acid in reducing hematoma expansion in patients with non-traumatic intracerebral hemorrhage.

What were the key findings regarding hematoma volume changes?

The study found no statistically significant difference in hematoma volume changes among the groups. However, the 3g TXA group exhibited a numerical reduction in volume, while both the placebo and 2g TXA groups showed expansion.

How many subjects participated in this study and their demographics?

A total of 60 subjects participated, with most being male (60%). The majority had known hypertension (71.7%) and presented with full Glasgow Coma Scale (GCS) scores.

Were there any adverse effects reported during the study?

No adverse effects were reported across all treatment groups, indicating that tranexamic acid appears to be safe for use in the studied dosages.

Glossary definitions and references:

Scientific and Ayurvedic Glossary list for “TANICH II: 3g Tranexamic Acid's Role in Hematoma Reduction”. 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) Study (Studying):
The term 'study' refers to a systematic investigation aimed at discovering, analyzing, and interpreting information about a specific topic or phenomenon, often through rigorous methodologies. In the context of medical research, a study assesses the effectiveness of treatments or interventions in human subjects, yielding insights that advance medical knowledge and practice.

2) Table:
A 'table' is a systematic arrangement of data, typically structured in rows and columns. In research papers, tables present numerical data for easy comparison and understanding of results, such as demographics or treatment outcomes. Tables enhance clarity and allow readers to quickly gauge important findings or trends in the data.

3) Blood:
Blood is vital for sustaining life, as it circulates throughout the body, delivering oxygen and nutrients to cells while removing carbon dioxide and waste products. In medical contexts, blood analysis can provide critical information regarding a patient's health, such as hemoglobin levels, clotting function, and indicators of infection or disease.

4) Post:
The word 'post' can indicate a sequence of events, typically referring to actions occurring after a specific point in time or after an event. In research, it often relates to assessments or observations made following an intervention or treatment, providing insights into its effectiveness and the patient's subsequent condition or recovery.

5) Bleeding:
'Bleeding' refers to the loss of blood from the circulatory system, which can be a result of injury, medical conditions, or surgical procedures. It is a critical concern in both trauma and surgery; managing bleeding effectively is crucial to prevent complications such as shock, organ failure, or even death.

6) Rules:
'Rules' denote established principles or regulations governing specific processes or procedures, often serving as standards for conduct or practice in various fields. In scientific research, rules ensure the integrity, reproducibility, and ethical treatment of study participants, thereby maintaining rigorous standards that lend credibility to the findings of the study.

7) Inflammation:
Inflammation is a biological response to injury or infection, characterized by redness, swelling, heat, and pain. It is a key component of the body's healing process but can also contribute to chronic illnesses. Understanding inflammation's role in diseases guides therapeutic interventions and can highlight underlying mechanisms affecting patient outcomes.

8) Calculation:
'Calculation' involves the process of determining numerical values or quantities based on data or formulas. In research, accurate calculations are essential for analyzing results, establishing statistical significance, and making informed decisions about treatment efficacy. They underpin the scientific method, ensuring the reliability and validity of study conclusions.

9) Knowledge:
'Knowledge' encompasses the information, understanding, and skills acquired through experience or education. It is the foundation of evidence-based practice in healthcare, guiding clinicians in decision-making. Accumulating and sharing knowledge through research studies improve patient care and outcomes, as ongoing education informs practice and fosters innovation in medical treatments.

10) Death:
'Death' refers to the cessation of biological functions that sustain a living organism. It is a critical endpoint in clinical studies, particularly in studies assessing the effectiveness of treatments for life-threatening conditions. Understanding mortality rates helps healthcare professionals evaluate the impacts of interventions and improve patient care strategies.

11) Drug:
A 'drug' is a substance used to diagnose, cure, treat, or prevent disease. In clinical research, assessing the efficacy and safety of drugs is vital for developing effective therapies. The outcomes of drug studies influence treatment guidelines, inform prescribing practices, and ultimately improve patient health outcomes across various medical conditions.

12) Male:
The term 'male' denotes one of the two primary biological sexes, characterized by specific anatomical and physiological traits. In clinical research, it is crucial to account for gender differences, as males and females may respond differently to treatments due to hormonal variations, genetics, and other factors influencing health and disease susceptibility.

13) Measurement:
'Measurement' refers to the process of quantifying physical quantities, such as size, volume, or concentration. In research, accurate measurement is essential for producing reliable data. It underpins reproducibility and validity in scientific studies, where precise metrics inform treatment efficacy, patient outcomes, and contribute to advancing knowledge in healthcare.

14) Observation:
'Observation' is the act of closely monitoring phenomena or subjects during a study. It plays a crucial role in research, especially in clinical settings, where direct observations provide valuable insights into patient responses, treatment outcomes, and adverse effects. Rigorous observational practices ensure data collection is thorough and informative for analysis.

15) Channel:
In the medical context, 'channel' can refer to anatomical or physiological pathways that facilitate the movement of substances, like blood vessels or nerve pathways. It may also describe mechanisms through which treatments are delivered or psychological pathways that influence patient responses. Understanding these channels aids in designing effective interventions.

16) Disease:
'Disease' denotes a specific pathological condition characterized by a disruption of normal bodily functions. It can arise from various causes, including infections, genetic disorders, and environmental factors. Understanding the mechanisms of disease processes is essential for developing effective treatments, public health interventions, and improving overall health outcomes in populations.

17) Mishra (Misra):
Mishra may refer to a notable figure in the field of research or medicine, possibly a researcher or clinician whose work contributes to the understanding of specific medical conditions or interventions, such as the use of tranexamic acid (TXA). Recognizing contributions from individuals helps to acknowledge ongoing advancements in healthcare.

18) Satya (Shatya):
Satya may indicate an individual, possibly a researcher or clinician, involved in relevant studies or contributions to medical knowledge. Naming researchers in scholarly articles highlights the collaborative nature of scientific investigation and acknowledges the work required to advance understanding and improve clinical practices in the medical field.

19) Belli:
Belli likely refers to a researcher or clinician who has contributed to studies in the medical field, particularly in relation to stroke or traumatic injury. Recognizing individuals’ contributions in their respective fields underscores the importance of collaboration and knowledge-sharing in advancing healthcare and treatment outcomes.

20) Glass:
The term 'glass' may denote a researcher or a researcher’s team member contributing to medical studies, particularly in areas related to brain injury or critical care. Acknowledging contributors in scientific literature enhances the recognition of collaborative efforts in research, promoting an understanding of the multidisciplinary nature of medical advancements.

21) Coca:
Coca appears to reference a significant contributor in the medical or research field, particularly relevant to studies on stroke management or acute cerebrovascular conditions. Such recognition emphasizes the collaborative effort in medical research, ensuring that important findings are attributed to the individuals and teams who dedicated their work to scientific discovery.

22) Mari:
Mari could represent a contributor or researcher who plays a role in studies related to medical conditions or interventions. Recognizing individuals in scholarly works emphasizes the collaborative nature of scientific research and the contributions that each investigator makes towards advancing knowledge and treatment options in healthcare.

23) Coma:
Coma is a state of prolonged unconsciousness, often resulting from severe injury, illness, or damage to the brain. It is an important clinical state to observe in studies that assess recovery, intervention effectiveness, and patient outcomes. Understanding outcomes in coma patients is critical for developing effective rehabilitation strategies.

24) Ter:
The term 'ther' possibly refers to therapeutic approaches or interventions discussed in medical research. In the context of studies about stroke or other emergencies, understanding various therapeutic strategies helps determine the most effective ways to enhance recovery, manage symptoms, and improve overall patient health outcomes.

25) Transformation (Transform, Transforming):
'Transformation' can refer to the process of change or adaptation in response to treatment or interventions. In medical research, analyzing how patients transform—physically, mentally, or functionally—provides insights into the effectiveness of therapies, ultimately guiding healthcare professionals in tailoring treatments to meet patients' needs.

26) Surrounding:
'Surrounding' refers to the environment or context in which a particular patient or condition exists. In clinical studies, understanding the surrounding factors, such as psychosocial elements or environmental influences, is crucial for informing effective patient care strategies and tailoring interventions that address broader influences on health outcomes.

27) Discussion:
'Discussion' in a research context involves interpreting the results, highlighting implications, limitations, and potential future directions. It is a critical component of scholarly articles, where authors engage with their findings, offering insights and drawing connections between the study's outcomes and existing literature to foster understanding and exploration.

28) Relative:
The term 'relative' may refer to the contextual relationship between varying factors or patients in medical studies. Understanding relative comparisons—such as treatment outcomes or risk factors—enhances the discussion and informs the assessment of the significance of findings in relation to existing knowledge and standards of care.

29) Pregnant:
The term 'pregnant' identifies women who are carrying developing offspring and is crucial when considering the effects of medications, treatments, and medical interventions. Research involving pregnant populations recognizes unique physiological changes and ethical considerations, ensuring that therapies are safe for both mothers and their unborn children, ultimately guiding clinical practice.

30) Account:
'Account' can refer to documentation or reporting of findings, treatment methods, or patient experiences within a study. An accurate account of data is fundamental in research, enabling transparent sharing of methods and results that contribute to evidence-based medical practices and the advancement of healthcare literature.

31) Surface:
The word 'surface' can signify the outer layer of a structure or organ as well as the setting for accessing tissues during medical procedures. In medical research, understanding surface interactions can inform approaches to treatment delivery, wound healing, and the tissue responses, thereby guiding practices aimed at optimizing patient care.

32) Family:
'Family' indicates the unit of relatives supporting or caring for individuals facing medical issues. Family dynamics are significant in health outcomes as they influence patient well-being, decision-making, and adherence to treatment, emphasizing the importance of involving family members in the healthcare process for holistic patient management.

33) Edema (Oedema):
'Oedema' describes the abnormal accumulation of fluid in tissues leading to swelling. It is an important clinical feature in various medical conditions, including stroke and intracerebral hemorrhage. Understanding its implications facilitates the management of conditions, influences treatment decisions, and guides interventions aimed at reducing associated complications.

34) Queen:
'Queen' likely refers to Queen Elizabeth II Hospital in Sabah, a facility mentioned in the study context. Recognizing healthcare settings highlights the environments where clinical research is conducted, emphasizing the role of local hospitals in advancing medical knowledge and improving patient outcomes through research and innovation.

35) Babu:
Babu may refer to an individual, possibly a researcher or contributor to clinical studies, particularly within specific populations or conditions. Acknowledging individuals' contributions fosters collaborative spirit in research, enhancing understanding of multifaceted approaches and the collective efforts necessary to progress medical science and improve patient propositions.

36) Beta:
The term 'beta' can refer to beta-blockers, a class of medications often used to manage blood pressure or heart conditions. In the context of stroke or intracerebral hemorrhage treatment, understanding the role of beta-blockers informs therapeutic decisions aimed at preventing complications and improving outcomes, thereby guiding clinical practices.

37) Peng:
Peng may reference a researcher or contributor involved in medical studies, particularly relevant to brain health or stroke management. Recognizing individuals contributes to the scientific community by encouraging collaboration and emphasizes the necessity of various expert contributions to improve healthcare outcomes and advance research frontiers.

38) Pur:
'Poor' often describes suboptimal health conditions or patient outcomes. In studies assessing treatments, acknowledging poor outcomes or responses informs understanding of treatment efficacy and patient care strategies. Insights gained can guide future research directions, address health disparities, and promote the development of targeted interventions aimed at improving care.

Other Health Sciences Concepts:

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Discover the significance of concepts within the article: ‘TANICH II: 3g Tranexamic Acid's Role in Hematoma Reduction’. Further sources in the context of Health Sciences might help you critically compare this page with similair documents:

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S.p.A., Outcome assessor, Planimetric measurement technique, Outcome assessment bias, Location of haematoma, Anti-hypertensive used, Duration of 1st CT brain, SBP (mmHg), GOS score, Different dosages of TXA, Numerical reduction of haematoma volume, Proven treatment, Non-surgical strategies, Perfusion pressure, Haemostatic therapy, Haemostatic agent, Reducing bleeding rates, Anti-fibrinolytic, Amino acid lysine, Plasminogen, Plasmin formation, Fibrin surface, Fibrinogenolysis, Dissolution of fibrin, Perihematomal oedema, Rapid TXA infusion, Pilot RCT, Pilot TXA trial, Aggressive SBP reduction, Parenteral or oral anti-hypertensives, Intensive BP reduction, Standard BP reduction, SBP of 130–139 mmHg, SBP lowering, Smaller haematoma volume, ICH prognosis, ICH-induced secondary brain injury, Acute inflammation reaction, Procoagulant state induced, Eosinophilic leucocyte count, Mean WBC count, GOS and mRS assessment, Functional outcome measure, Good recovery scores, Adverse reaction reported, 3-g TXA regime, Multicentre recruitment, Acute stroke registry, Early deterioration after spontaneous intracerebral hemorrhage, Post admission hematoma expansion, Intraparenchymal hemorrhage, Hypertensive intracerebral hemorrhage, Inflammation mediates ICH-induced, Haematoma expansion was inversely, Haematoma expansion was directly, Eosinophil counts were robustly, Study subjects were, Reducing haematoma volume, No adverse reaction, Time constraints as, Future research targeting, Ethical approval from, Double-blinded randomised, Mean expansion, Larger-scale randomised, Hypertension with intravenous, Coagulopathy if present, Strict SBP optimisation, Doubleblinded randomised, Repeat CT brain, Main study outcome, Haematoma outcome assessment, SBP and white, Safety of TXA, Patient's GOS, Effects of three, Changes in haematoma size, P-value of less, Majority were male, Demographics of subject, ANCOVA was employed, SBP and total, Statistically lower, Other outcomes, Moderately disabled, Numerical reduction, Fibrinolytic agent, Lysine binding sites, Directly inhibit plasmin, Fibrinogenolysis at higher, Stabilising the clot, Further haemorrhage, Anti-inflammatory and neuroprotective, Haematoma cavity, Surrounding gliosis, Non-significantly more, Hypothesis-generating, Intensive blood pressure, INTERACT-2 trial, SBP reduction, Relevance of leucocyte, Treatment target, Legalised authorised representative, Slow bolus, Neuro-surgery ward, Haematoma expansion in hypertensive ICH, CT films, Intensive blood pressure reduction, Haematoma enlargement, GOS and mRS, Study subjects managing.

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