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Erschienen in: Notfall + Rettungsmedizin 8/2019

15.06.2018 | Leitthema

Blutungsmanagement: Tranexamsäure in der Präklinik. Pro und Kontra

verfasst von: Dr. H. Lier, Professor Dr. M. Maegele

Erschienen in: Notfall + Rettungsmedizin | Ausgabe 8/2019

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Zusammenfassung

Das Antifibrinolytikum Tranexamsäure (TXA) ist in den letzten Jahren zunehmend in den Fokus der Gerinnungstherapie traumatisierter Patienten gekommen. Basierend auf den Ergebnissen der prospektiven, multizentrischen „Clinical Randomization of an Antifibrinolytic in Significant Hemorrhage-2 (CRASH-2)“-Studie an 20.211 Traumapatienten kam es in Europa sehr rasch zu hochgradigen Empfehlungen für TXA. Die Übertragbarkeit der Ergebnisse auf moderne, hoch entwickelte Notarztsysteme wird jedoch zunehmend infrage gestellt und durch einige Studien bezweifelt. Auch lassen die fortschreitenden Kenntnisse der traumainduzierten Gerinnungsstörung mit unterschiedlichen Phänotypen eine universelle Anwendung von TXA bei jedem Trauma nicht sinnvoll erscheinen. TXA ist ein Medikament, als solches benötigt es eine Indikation, hat Wirkungen, aber auch Nebenwirkungen. Gerade bei schwerverletzen Patienten, der laut aktuellen Empfehlungen primären Zielgruppe, gibt es Hinweise auf eine reduzierte Sterblichkeit, aber zunehmend auch auf thromboembolische Effekte. Evidenzbasierte Aussagen zur prähospitalen Gabe von TXA werden erst durch die Auswertung aktuell laufender Studien möglich sein.
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Metadaten
Titel
Blutungsmanagement: Tranexamsäure in der Präklinik. Pro und Kontra
verfasst von
Dr. H. Lier
Professor Dr. M. Maegele
Publikationsdatum
15.06.2018
Verlag
Springer Medizin
Erschienen in
Notfall + Rettungsmedizin / Ausgabe 8/2019
Print ISSN: 1434-6222
Elektronische ISSN: 1436-0578
DOI
https://doi.org/10.1007/s10049-018-0471-2

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