Clinical pathology selected abstracts
May 2024—Massive hemorrhage is a major cause of death in children, and the mortality rate from life-threatening hemorrhage is estimated to be 20 to 51 percent. To counter this high mortality rate, clinicians have sought to standardize massive transfusion protocols and hemostatic resuscitation, ensuring that protocols support balanced blood-based resuscitation or the use of low titer group O whole blood, or both. These protocols may include using the lysine analogue antifibrinolytics tranexamic acid (TXA) and epsilon aminocaproic acid (EACA) in children with life-threatening hemorrhage (LTH). However, use of these antifibrinolytics is much more common in adult trauma patients. Study data suggest that TXA may increase survival outcomes in adults with traumatic injury, postpartum hemorrhage, nontraumatic intracranial hemorrhage, and all-cause bleeding.