Hemodynamics, fluids & transfusion
Tranexamic Acid vs Adrenaline for Controlling Iatrogenic Bleeding During Flexible Bronchoscopy: A Double-Blind Randomized Controlled Trial
Authors' conclusion
We found no significant difference between adrenaline and TXA for controlling noncatastrophic iatrogenic endobronchial bleeding after cold saline failure
Study context
- Population
- Patients with iatrogenic bleeding during flexible bronchoscopy after hemostasis failure with three applications of cold saline, tertiary teaching hospitalrandomized
- Participants
- 130 patients
- Comparison
- Tranexamic acid (TXA) vs adrenaline after cold saline failure
- TXAn = 65
- Adrenalinen = 65reference
- Primary endpoint
- Bleeding stopped
Methodological detailscluster-randomized, double-blind, single-center, Randomized in weekly clusters, Crossover allowed for up to three further applications, 12 excluded for protocol violations (2 adrenaline, 10 TXA)
- Cluster-randomized
- Double-blind
- Single-center
- Randomized in weekly clusters
- Crossover allowed for up to three further applications
- 12 excluded for protocol violations (2 adrenaline, 10 TXA)
Primary result
As reported in the abstract
P = 1
Further findings
Bleeding control, moderate vs severe bleeding (subgroup) — Adrenaline, moderate vs Adrenaline, severe · value = moderate bleeding
P = 0.008
Severe bleeding
| Outcome | TXA | Adrenaline | P value |
|---|---|---|---|
| Bleeding severity (VAS, 1 = very mild, 10 = severe) | mean 5.3 ± 1.4 | mean 4.9 ± 1.3 | |
| Number of applications needed for bleeding control | 1.8 ± 0.8 | 1.8 ± 0.8 | |
| Bleeding control, moderate vs severe bleeding (subgroup)TXA, moderate vs TXA, severe · value = moderate bleeding | P = 0.012 | ||
| Applications needed, severe vs moderate bleeding (subgroup)Adrenaline, severe vs Adrenaline, moderate · value = severe bleeding | 2.4 ± 0.5 | 3.0 ± 0 | P = 0.006 |
| Moderate bleeding | 1.7 ± 0.8 | 1.7 ± 0.8 | |
| Applications needed, severe vs moderate bleeding (subgroup)TXA, severe vs TXA, moderate · value = severe bleeding | P = 0.002 |
Bleeding severity (visual analog scale (VAS), 1 = very mild, 10 = severe)
- Similar in both groups
Number of applications needed for bleeding control
- Similar in both groups
Safety
Events
| Outcome | TXA | Adrenaline |
|---|---|---|
| Drug-related adverse events | 0 | 0 |
Original publication
Tranexamic Acid vs Adrenaline for Controlling Iatrogenic Bleeding During Flexible Bronchoscopy: A Double-Blind Randomized Controlled Trial. Chest. Published 21 October 2022. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →