high-dose tranexamic acid reduces blood loss in postpartum haemorrhage大剂量氨甲环酸减少失血,产后出血.pdfVIP

Ducloy-Bouthors et al. Critical Care 2011, 15:R117 /content/15/2/R117 RESEARCH Open Access High-dose tranexamic acid reduces blood loss in postpartum haemorrhage 1* 2,3 4,5 6 7 Anne-Sophie Ducloy-Bouthors , Brigitte Jude , Alain Duhamel , Françoise Broisin , Cyril Huissoud , Hawa Keita-Meyer8,9, Laurent Mandelbrot9,10, Nadia Tillouche11, Sylvie Fontaine11, Françoise Le Goueff12, Sandrine Depret-Mosser13, Benoit Vallet1,14, for The EXADELI Study Group15 and Sophie Susen2,3 Abstract Introduction: Our purpose in conducting this study was to determine whether administration of high-dose tranexamic acid (TA) at the time of diagnosis of postpartum haemorrhage (PPH) could reduce blood loss. Methods: This was a randomised, controlled, multicentred, open-label trial. Women with PPH 800 mL following vaginal delivery were randomly assigned to receive TA (loading dose 4 g over 1 hour, then infusion of 1 g/hour over 6 hours) or not. In both groups, packed red blood cells (PRBCs) and colloids could be used according to French guidelines. The use of additional procoagulant treatments was permitted only in cases involving intractable bleeding. The primary objective was to assess the efficacy of TA in the reduction of blood loss in women with PPH, and the secondary objectives were the effect of TA on PPH duration, anaemia, transfusion and the need for invasive procedures. Results: A total of 144 women fully completed the protocol (72 in each group). Blood loss between enrolment and 6 hours later was significantly lower in the TA group than in the control group (median, 173 mL; first to third quartiles, 59 to 377) than in controls (221 mL; first to third quartiles 105 to 564) (P = 0.041). In th