Tranexamic acid: less bleeding and less thrombosis?

Crit Care. 2012 Jun 29;16(3):135. doi: 10.1186/cc11374.


The early administration of tranexamic acid (TXA) to bleeding trauma patients reduces all-cause mortality without increasing the risk of vascular occlusive events. Indeed, the risk of arterial thrombosis appears to be reduced with TXA. In this commentary we hypothesize that TXA has an antithrombotic effect and explore potential mechanisms. These include inhibition of the inflammatory effects of plasmin, effects on platelets and effects on factors V and VIII. If proven, these antithrombotic effects would have major implications for the systemic use of TXA in surgical patients, where TXA has been clearly shown to reduce bleeding.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Antifibrinolytic Agents / therapeutic use*
  • Factor V / drug effects
  • Factor VIII / drug effects
  • Fibrinolysin / antagonists & inhibitors
  • Hemorrhage / drug therapy*
  • Hemorrhage / etiology
  • Humans
  • Plasminogen / antagonists & inhibitors
  • Platelet Activation / drug effects
  • Tranexamic Acid / therapeutic use*
  • Wounds and Injuries / complications*


  • Antifibrinolytic Agents
  • Tranexamic Acid
  • Factor V
  • Factor VIII
  • Plasminogen
  • Fibrinolysin