Tranexamic acid in patients with hemoptysis.
Hemoptysis is a common respiratory symptom leading to admission to hospital. The main management of hemoptysis depends on treating the underlying cause. The use of tranexamic acid is recommended by many doctors without much information available.
                This study was a randomized double blinded placebo controlled trial in using tranexamic acid (Transamine) in hemoptysis patients. The study period was one week. Patients with hemoptysis were separated into 3 groups depending on the amount of blood. Group 1 consisted of patients with blood streak sputum. Group 2 coughed up less than 20 ml of frank blood. Patients in Group 3 were those who coughed up 20-500 ml of blood per day. A record of the amount of bleeding and drug side effects was done.
                From June 1994 to May 1997, 46 patients with hemoptysis completed the study. There were 21 in the tranexamic acid group and 25 in the placebo group. The placebo group had a tendency not to have underlying lung disease and more patients who had a normal chest X-ray. The benefit of tranexamic acid in shortening the days of hemoptysis is not shown in this study. There was a low incidence of side effects of tranexamic acid in this study.
                This randomized double blinded placebo controlled trial could not demonstrate the benefit of tranexamic acid in shortening the days of hemoptysis and confirm the low incidence of side effects of this drug.
There is insufficient evidence to judge whether antifibrinolytics should be used to treat haemoptysis from any cause, though limited evidence suggests they may reduce the duration of bleeding.