Tranexamic Acid Is Not for Everyone: What the Mega-Trials Revealed скачать в хорошем качестве

Tranexamic Acid Is Not for Everyone: What the Mega-Trials Revealed

Tranexamic acid has become one of the most widely used drugs in modern perioperative medicine. But is its use always supported by physiology and evidence? In this episode of Niko’s Perioperative, Dr. Nicolás Valls analyzes the landmark randomized trials that reshaped how anesthesiologists think about antifibrinolytic therapy. From CRASH-2 and WOMAN to POISE-3, ATACAS, HALT-IT, and HeLiX, we explore when tranexamic acid saves lives, and when extrapolation may expose patients to unnecessary risk. This is a deep dive into precision perioperative medicine, therapeutic windows, and the evolving role of evidence in anesthesia practice. Because modern anesthesiology is not about reflex , it is about recognition. Topics Covered: • Hyperfibrinolysis and bleeding physiology • Trauma and postpartum hemorrhage • Major noncardiac surgery • Cardiac anesthesia and seizure risk • Negative mega-trials • The therapeutic window of TXA Timestamps 00:00 Open 00:59 Why Tranexamic Acid Became a Reflex 01:39 The New Question 01:54 CRASH-2 — When Mortality Moves 02:50 CRASH-3 — Salvageable Physiology 03:24 WOMAN — Mortality-Level Evidence 04:02 TRAAP — TRAAP2 The Limits of Prophylaxis 04:41 POISE-3 — The OR Grows Up 05:18 ATACAS — The Neurologic Tradeoff 05:50 HALT-IT — Learning When NOT to Treat 06:17 HeLiX — The Extrapolation Trap 06:47 Final Thoughts — From Reflex to Precision