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- accident & emergency medicine
- trauma management
- adult intensive & critical care
The incidence of traumatic brain injury (TBI) is rising, with over 60 million people affected annually across the globe. 1 Tranexamic acid (TXA) is an inhibitor of fibrinolysis, which is readily available, easily administered, can be given in the prehospital phase and has been shown to have a good safety profile in trauma.2 Following the CRASH-2 trial, which showed a significant reduction in deaths from major extracranial bleeding in patients who had TXA administered within 3 hours of injury, CRASH-3 (Effects of tranexamic acid on death, disability, vascular occlusive events and other morbidities in patients with acute traumatic brain injury (CRASH-3): a randomised, placebo-controlled trial) was established as a large international multi-centred randomised placebo-controlled trial which investigated the effect of TXA in patients with an isolated TBI. 3
Patients were randomised to either TXA (1 g …
Contributors Both TB and AN are free from conflicts of interest and played an equal part in the authorship of this article.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Provenance and peer review Commissioned; internally peer reviewed.