High-dose Continuous Infusion of Tranexamic Acid for Controlling Life-threatening Bleed in Advanced Cancer Patients.
High-dose Continuous Infusion of Tranexamic Acid for Controlling Life-threatening Bleed in Advanced Cancer Patients.
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DOI：
10.4103/ijpc.ijpc_48_20
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发表时间：
2021-01
影响因子：
1.1
通讯作者：
Atreya S
中科院分区：
文献类型：
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作者：
Atreya S
危及生命的出血虽然在姑息治疗中不常见，但与患者和家属的重大痛苦有关。目前的指南强调需要识别具有早期出血体征的患者，并在发生事件时为患者和家属提供保证和舒适护理。关于高剂量氨甲环酸（一种赖氨酸类似物）在控制出血中的作用，无论出血的潜在病理生理学如何，都知之甚少。已知氨甲环酸竞争性阻断纤溶酶原的赖氨酸结合位点，从而抑制纤溶酶原活化为纤溶酶，并且在高浓度下氨甲环酸非竞争性阻断纤溶酶，从而抑制纤溶酶溶解和降解纤维蛋白凝块。在这里，我们讨论了两个病例研究的病人谁提出了大量出血的肿瘤部位。通过高剂量持续静脉输注氨甲环酸，出血完全停止，输血需求减少。
Life-threatening bleeding although uncommon in palliative care is associated with significant distress among patients and family. The current guidelines emphasize the need for identification of a patient with early signs of bleeding and providing assurance and comfort care to patients and family in case of an event. There is very little known about the role of high dose of tranexamic acid, a lysine analog in controlling the bleeding irrespective of the underlying pathophysiology of the bleed. Tranexamic acid is known to competitively block the lysine-binding site of plasminogen and thus inhibit the activation of plasminogen to plasmin and at high-concentration tranexamic acid noncompetitively blocks plasmin, thus inhibiting the dissolution and degradation of fibrin clots by plasmin. Here, we discuss two case studies of patients who presented with massive bleed from the tumor site. With a high dose of continuous intravenous infusion of tranexamic acid, there was a complete arrest of the bleed with a reduction in the requirement for blood transfusion.