{"id":25788,"date":"2024-06-12T04:52:00","date_gmt":"2024-06-11T20:52:00","guid":{"rendered":"http:\/\/csccm.org.cn\/?p=25788"},"modified":"2024-06-12T05:33:57","modified_gmt":"2024-06-11T21:33:57","slug":"icu-management-practice-%e6%b0%a8%e7%94%b2%e7%8e%af%e9%85%b8%e6%b2%bb%e7%96%97%e8%82%9d%e7%a1%ac%e5%8c%96%e6%82%a3%e8%80%85%e6%80%a5%e6%80%a7%e4%b8%8a%e6%b6%88%e5%8c%96%e9%81%93%e5%87%ba%e8%a1%80","status":"publish","type":"post","link":"https:\/\/csccm.org.cn\/?p=25788","title":{"rendered":"[ICU Management &#038; Practice]: \u6c28\u7532\u73af\u9178\u6cbb\u7597\u809d\u786c\u5316\u60a3\u8005\u6025\u6027\u4e0a\u6d88\u5316\u9053\u51fa\u8840"},"content":{"rendered":"\n<h1 class=\"wp-block-heading\">Tranexamic Acid for Acute UGIB in Patients With Cirrhosis<\/h1>\n\n\n\n<ul>\n<li>In&nbsp;<a href=\"https:\/\/healthmanagement.org\/c\/icu\">ICU<\/a><\/li>\n\n\n\n<li>Tue, 12 Mar 2024<\/li>\n<\/ul>\n\n\n\n<figure class=\"wp-block-image size-large\"><img decoding=\"async\" src=\"https:\/\/res.cloudinary.com\/healthmanagement-org\/image\/upload\/c_fit,f_auto,fl_lossy,h_690,q_90,w_450\/v1710240728\/cw\/00126486_cw_image_wi_d7bd76b70fa236a23d48f6ebad3e00da.jpg\" alt=\"\"\/><\/figure>\n\n\n\n<p>A recent study aimed to assess the effectiveness and safety of tranexamic acid in treating acute upper gastrointestinal bleeding (UGIB) in patients with cirrhosis, particularly those classified as Child-Turcotte-Pugh (CTP) class B and C. These patients experience systemic and localised fibrinolysis in the mucosa of the oesophagus and stomach.<\/p>\n\n\n\n<p><br \/>The study included 600 patients with advanced liver cirrhosis (CTP class B or C) and UGIB. Patients were randomly assigned to receive either tranexamic acid (300 patients) or a placebo (300 patients). The primary outcome of the study was the proportion of patients experiencing treatment failure within five days.<\/p>\n\n\n\n<p>As per the results, failure to control bleeding by day 5 occurred in 6.3% (19 out of 300) of patients in the tranexamic acid group compared to 13.3% (40 out of 300) in the placebo group. Among patients undergoing first-time oesophageal variceal ligation (EVL), excluding those with previous post-EVL ulcer bleeding, failure to control bleeding by day 5 at the oesophageal EVL site was seen in 4.9% (11 out of 222) in the tranexamic acid group and 12.0% (27 out of 225) in the placebo group. However, 5-day and 6-week mortality rates were similar between the tranexamic acid and placebo groups.<\/p>\n\n\n\n<p>These findings show that tranexamic acid effectively reduces the failure to control bleeding by day 5 and the risk of rebleeding after day 5 up to 6 weeks in patients with CTP class B or C presenting with UGIB. This reduction in bleeding is particularly evident in preventing bleeding from the EVL site.<\/p>\n\n\n\n<p>Source:&nbsp;<a href=\"https:\/\/journals.lww.com\/hep\/abstract\/9900\/tranexamic_acid_in_upper_gastrointestinal_bleed_in.771.aspx\" target=\"_blank\" rel=\"noreferrer noopener\">Hepatology<\/a><br \/>Image Credit: iStock&nbsp;<\/p>\n\n\n\n<p><a href=\"https:\/\/healthmanagement.org\/c\/icu\/news\/multidisciplinary-management-of-gram-negative-bloodstream-infections\">\u00ab\u00ab&nbsp;Multidisciplinary Management of Gram-Negative Bloodstream Infections<\/a><\/p>\n\n\n\n<p><a href=\"https:\/\/healthmanagement.org\/c\/icu\/news\/ventilator-parameters-during-or-to-icu-transition\">Ventilator Parameters During OR\u2013to\u2013ICU Transition \u00bb\u00bb<\/a><\/p>\n\n\n\n<h4 class=\"wp-block-heading\">References:<\/h4>\n\n\n\n<p>Kumar M, Venishetty S, Jindal A et al. (2024)&nbsp;<a href=\"https:\/\/journals.lww.com\/hep\/abstract\/9900\/tranexamic_acid_in_upper_gastrointestinal_bleed_in.771.aspx\" target=\"_blank\" rel=\"noreferrer noopener\">Tranexamic acid in upper gastrointestinal bleed in patients with cirrhosis - a randomized controlled trial.<\/a>&nbsp;Hepatology.&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Tranexamic Acid for Acute UGIB in Patients With Cirrhos [&hellip;]<\/p>\n","protected":false},"author":3,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":[],"categories":[24,23],"tags":[],"_links":{"self":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/25788"}],"collection":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=25788"}],"version-history":[{"count":1,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/25788\/revisions"}],"predecessor-version":[{"id":25789,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/25788\/revisions\/25789"}],"wp:attachment":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=25788"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=25788"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=25788"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}