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Efficacy and Safety of Tranexamic Acid Administration in Patients with Acute Traumatic Brain Injury: A Review of Current Literature

December 10, 2022/in July-December 2022 | Volume 8 | Issue 2

Vol 8 | Issue 2 | July-December 2022 | page: 06-12 | Kenzie Kao, Mohammed Alsabri DOI: https://doi.org/10.13107/ti.2022.v08i02.027 Authors: Kenzie Kao [1], Mohammed Alsabri [2] [1] Saba University School of Medicine, Saba, Dutch Caribbean, Netherlands. [2] Department of Emergency Medicine, Al-Thawra Modern General Teaching Hospital, Sana’a City, Yemen. Address of Correspondence Dr. Mohammed Alsabri, Department […]

Management of a Polytrauma Case In a Resource-Constrained Hospital

December 10, 2022/in July-December 2022 | Volume 8 | Issue 2

Vol 8 | Issue 2 | July-December 2022 | page: 21-25 | Daniel Mossalbaye Adendjingue, S. Pascal Chigblo, Oswald Goukodadja, Adebola Padonou, Iréti Fiacre Tidjani, Aristote Hans-Moevi Akue DOI: https://doi.org/10.13107/ti.2022.v08i02.0230 Authors: Daniel Mossalbaye Adendjingue [1], S. Pascal Chigblo [2], Oswald Goukodadja [2], Adebola Padonou [2], Iréti Fiacre Tidjani [2], Aristote Hans-Moevi Akue [2] [1] Department […]

Efficacy and Safety of Tranexamic Acid Administration in Patients with Acute Traumatic Brain Injury: A Review of Current Literature

December 10, 2022/in July-December 2022 | Volume 8 | Issue 2

Management of a Polytrauma Case In a Resource-Constrained Hospital

December 10, 2022/in July-December 2022 | Volume 8 | Issue 2

Full Sized Blog Element (Big Preview Pic)

Efficacy and Safety of Tranexamic Acid Administration in Patients with Acute Traumatic Brain Injury: A Review of Current Literature

December 10, 2022/in July-December 2022 | Volume 8 | Issue 2

Vol 8 | Issue 2 | July-December 2022 | page: 06-12 | Kenzie Kao, Mohammed Alsabri

DOI: https://doi.org/10.13107/ti.2022.v08i02.027

Authors: Kenzie Kao [1], Mohammed Alsabri [2]

[1] Saba University School of Medicine, Saba, Dutch Caribbean, Netherlands. [2] Department of Emergency Medicine, Al-Thawra Modern General Teaching Hospital, Sana’a City, Yemen.

Address of Correspondence

Dr. Mohammed Alsabri,

Department of Emergency Medicine, Al-Thawra Modern General Teaching Hospital, Sana’a City, Yemen.

E-mail: alsabri5000@gmail.com

Abstract

Hypothesis: Early administration of tranexamic acid (TXA) reduces mortality in patients suffering from acute traumatic brain injury (TBI).

Methods: A structured search of PubMed and CENTRAL from inception until July 1st, 2022 was carried out seeking RCTs comparing the effects of TXA administration to placebo in patients suffering from TBI. The primary outcome tested was 28-day all-cause mortality. Secondary outcomes included intracranial hemorrhage growth and thromboembolic events.

Results: Eight RCTs involving a total of 14,714 patients met the inclusion criteria; 7573 patients received TXA while 7141 patients received a placebo. There were 1415 patient deaths (18.7%) in the TXA group and 1410 patient deaths (19.7%) in the placebo group. None of the included studies reported a significant reduction in 28-day all-cause mortality, however, they all shared positive trends toward superior outcomes in the intervention arms. Two of the included studies reported significant reductions in intracranial hemorrhage expansion in those patients treated with TXA, with four more studies reporting trends toward superior outcomes in the TXA groups. There was no evidence of increased incidence of thromboembolic events in the TXA groups in four of the five studies that reported relevant data, with one study representing 1.2% of total patients reporting an increased incidence of pulmonary emboli in the intervention group.

Conclusions: In patients suffering from acute TBI, early administration of TXA reduces intracranial hemorrhage growth and may have positive effects on mortality with no corresponding increase in thromboembolic events. Given these results, early administration of TXA in patients experiencing TBI is recommended in initial care.

Keywords: Tranexamic acid, Traumatic brain injury, Intracranial hemorrhage, Mortality, Disability

References

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How to Cite this article: Kao K, Alsabri M | Efficacy and Safety of Tranexamic Acid Administration in Patients with Acute Traumatic Brain Injury: A Review of Current Literature | July-December 2022; 8(2): 06-12. https://doi.org/10.13107/ti.2022.v08i02.027

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Management of a Polytrauma Case In a Resource-Constrained Hospital

December 10, 2022/in July-December 2022 | Volume 8 | Issue 2

Vol 8 | Issue 2 | July-December 2022 | page: 21-25 | Daniel Mossalbaye Adendjingue, S. Pascal Chigblo, Oswald Goukodadja, Adebola Padonou, Iréti Fiacre Tidjani, Aristote Hans-Moevi Akue

DOI: https://doi.org/10.13107/ti.2022.v08i02.0230

Authors: Daniel Mossalbaye Adendjingue [1], S. Pascal Chigblo [2], Oswald Goukodadja [2], Adebola Padonou [2], Iréti Fiacre Tidjani [2], Aristote Hans-Moevi Akue [2]

[1] Department of Orthopedic-Traumatology, National Teaching Hospital CHU-RN, N’Djamena-Chad. [2] Department of Orthopedic-Traumatology, National Teaching Hospital CNHU-HKM, Cotonou, Benin.

Address of Correspondence

Dr. Daniel Mossalbaye Adendjingue,

Department of Orthopedic-Traumatology, National Teaching Hospital CHU-RN, N’Djamena-Chad.

E-mail: dendjinguedaniel@gmail.com / adendjingue@yahoo.fr

Abstract

Introduction: The management of polytrauma patient should be beforehand and always in keeping in mind the damage control. the surgical treatment is secondary to the stabilization of the patient.

Clinical Case: we are reporting a 34 years old polytrauma patient from a motor vehicle accident. On physical examination, we noted : a severe brain injury, a closed articular fracture of right distal radius associated to a dislocation of distal radius and ulna distal joint, a closed bilateral fracture of both trochanters, an open communitive tibial fracture of proximal epiphysis methaphysis and diaphysis. The last one was classified as type IIIB of Gustilo and Anderson and associated to a closed fracture of the head and the neck of right fibula, a closed fracture of the right lateral malleolus. After patient stabilization, the head injury improves to normal Glasgow score on 8th day of admission. Necrosis of soft tissus and exposition of the tibia was noted. The surgical treatment was done on 2 stages due to financial issues. A bone synthesis of the trochanteric fracture was done only on the left and external frame as well as a muscle flap was done for the right tibial fracture on the 18th day. On the 42nd day a PAPINEAU technic associated to a proximal inter tibiofibular graft was done. The functional outcome of the orthopaedic treatment of the wrist was bad (malunion). That last complication was managed by a SAUVE KAPANDJI surgery (at 6 months) and the contracture (pronation and supination) at 12 months post trauma. The outcome was fair good despite patient financial issue and local complications that compromise an optimal surgical management and a delay. He resumes normal professional activities at about 2 years. At 5 years follow up, functional and anatomical results were satisfactory.

Conclusion: In a limited ressources’ setting, the management of lesions including a multiple fractures is a challenge for the practitioner and the injuried patient. A management taking into account social and economic ressources is mandatory to minimise sequelae. Keywords: Management, Polytrauma, Limited ressources.

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How to Cite this article: Adendjingue DM, Chigblo SP, Goukodadja O, Padonou A, Tidjani IF, Akue AHM | Management of a Polytrauma Case In a Resource-Constrained Hospital | July-December 2022; 8(2): 21-25 | https://doi.org/10.13107/ti.2022.v08i02.030

Half Sized Blog Element (Single Author Style)

Half Sized Blog Element (Multi Author Style)

Efficacy and Safety of Tranexamic Acid Administration in Patients with Acute Traumatic Brain Injury: A Review of Current Literature

Management of a Polytrauma Case In a Resource-Constrained Hospital

Efficacy and Safety of Tranexamic Acid Administration in Patients with Acute Traumatic Brain Injury: A Review of Current Literature

Management of a Polytrauma Case In a Resource-Constrained Hospital

Full Sized Blog Element (Big Preview Pic)

Efficacy and Safety of Tranexamic Acid Administration in Patients with Acute Traumatic Brain Injury: A Review of Current Literature

Authors: Kenzie Kao [1], Mohammed Alsabri [2]

Abstract

References

(Abstract Text HTML) (Download PDF)

Management of a Polytrauma Case In a Resource-Constrained Hospital

Authors: Daniel Mossalbaye Adendjingue [1], S. Pascal Chigblo [2], Oswald Goukodadja [2], Adebola Padonou [2], Iréti Fiacre Tidjani [2], Aristote Hans-Moevi Akue [2]

Abstract

References

(Abstract Text HTML) (Download PDF)

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