Effect of tranexamic acid on children with traumatic bleeding: A systematic review and meta-analysis.
The American journal of emergency medicine · 2025-07-03 · Meta-analysis
Abstract
BACKGROUND: This systematic review and meta-analysis aimed to evaluate the efficacy and safety of tranexamic acid (TXA) in the treatment of traumatic bleeding in children. METHODS: We searched Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Embase, MEDLINE, Web of Science for relevant cohort and randomized controlled trials, excluding studies with other anti-bleeding treatments or patients with underlying bleeding disorders. Outcomes included mortality, ICU admission, surgical intervention, transfusions, hospital stay, seizures, and thromboembolic events. Statistical analysis employed odds ratios (OR) in random-effects models. RESULTS: Ten studies (1 randomized controlled trial, 9 retrospective cohorts; n = 34,144) were included. The pooled results revealed that TXA significantly reduced mortality (OR 0.58; 95 % CI, 0.38-0.89), especially with a 1 g initial dose. However, no significant differences were found in other outcomes. TXA use was associated with a slight increase in seizures but no rise in thromboembolic events. The overall safety profile was favorable. CONCLUSION: Our study highlights the potential benefits of TXA in reducing mortality in pediatric trauma cases and underscores the need for further research to determine optimal dosing and timing strategies.
Abstract © the authors or publisher, via PubMed. Reuse and removal
Tags
Children · Haemostatics · Mortality & survival · Tranexamic acid
Related articles
- Effectiveness and safety of tranexamic acid in pediatric trauma: A systematic review and meta-analysis. (Am J Emerg Med, 2022)
- Pediatric Massive Transfusion: A Systematic Review. (Pediatr Emerg Care, 2018)
- Efficacy and Safety of Tranexamic Acid in Pediatric Trauma: A Systematic Review and Meta-Analysis. (J Pediatr Pharmacol Ther, 2026)
- Clinical outcomes of hemostatic interventions in patients with traumatic injury: A systematic review of randomized controlled trials. (J Trauma Acute Care Surg, 2026)
- Comparative efficacy of prehospital resuscitation strategies on mortality for patients with major trauma: a network meta-analysis. (Eur J Emerg Med, 2026)
- The use of tranexamic acid in the management of injured patients at risk of hemorrhage: a systematic review and meta-analysis and an Eastern Association for the Surgery of Trauma Practice Management Guideline. (J Trauma Acute Care Surg, 2025)