Can delirium after major surgery be reduced by tranexamic acid?

ANZCA funded study will look at whether tranexamic acid can
reduce confusion and delirium after major surgery.

Congratulations to Professor Paul Myles on his grant from the Australia and New Zealand College of Anaesthetists (ANZCA) of $120,000 over two years for the project "Tranexamic acid to reduce delirium after gastrointestinal surgery: the TRIGS-D trial".

Delirium is a devastating complication of medical and surgical care, associated with increased morbidity and mortality, dementia and impaired long-term cognition, and loss of independence. 

Researcher awarded $5 million by NHMRC for trial into post-surgery infection drug

Tranexamic acid (TXA) is used to reduce
 excessive bleeding. There is also evidence that
 TXA has immune-protective effects.

by Anne Crawford

Professor Paul Myles, Director of the Department of Anaesthesia and Perioperative Medicine in Central Clinical School and at The Alfred, has been awarded a $5.19 million Clinical Trials and Cohort Studies (CTCS) grant from the National Health and Medical Research Council (NHMRC) to conduct an international trial of a medication that could prevent infections after surgery.

Congratulations to Professor Paul Myles on winning Clinical Trial of the Year!

Professor Paul Myles with Minister Greg Hunt MP at the award
ceremony, Friday 19 May 2017. Photo: Sophie Wallace

Professor Paul Myles (pictured) has won Clinical Trial of the Year, awarded by the Australian Clinical Trials Alliance.  The award was presented by the Federal Health Minister, the Hon Greg Hunt MP, on Friday 19 May 2017.

Major surgery outcomes improved with TXA

Tranexamic acid (TXA) reduces the risk of
serious bleeding complications by 40%

New research shows the medication TXA could nearly halve the number of people who suffer complications with bleeding following open heart and other major surgery.

Tranexamic acid (TXA) reduces the risk of serious bleeding complications by 40 per cent, resulting in fewer blood transfusions and emergency re-operations, according to a global study which involved 30 hospitals in seven countries. It was led by a team at the Alfred Hospital and Monash University.

Doctors had been concerned about using TXA because of fears that it might increase the risk of heart attack or stroke. But the world-wide study, funded by the Australian and New Zealand College of Anaesthetists (ANZCA) and the NHMRC, found that the drug did not increase thrombosis after open-heart surgery.

Trauma drug TXA good before 3 hours, not so good after 3 hours - why?

Tranexamic Acid (TXA)

Why is it that an antifibrinolytic drug that is given to reduce bleeding in severe trauma patients can sometimes cause the very thing it is intended to stop? Professor Rob Medcalf explains the paradox in a published commentary that throws light on how the fibrinolytic system (that removes blood clots) can be inadvertently turned on when it should be turned off.

Tranexamic acid, or TXA for short, was extensively tested in 2010, in a trial of severe trauma patients called CRASH-2. The results showed improved outcomes if TXA was administered in the three hours immediately after injury, but after three hours, more deaths were caused due to bleeding. This commentary summarises the results of a study from a group in the US describing how TXA is doing different things at different times following head injury.

Reference: http://www.bloodjournal.org/content/bloodjournal/125/16/2457.full.pdf