Podcast 873: Intravesical Tranexamic Acid for Gross Hematuria

<p dir="ltr"><strong>Contributor: Aaron Lessen MD</strong></p> <p dir="ltr"><strong>Educational Pearls:</strong></p> <ul> <li dir="ltr" aria-level="1"> <p dir="ltr" role="presentation">Tranexamic acid (TXA) is a common medication to achieve hemostasis in a variety of conditions</p> </li> <li dir="ltr" aria-level="1"> <p dir="ltr" role="presentation">Patients visiting the ED for gross hematuria (between March 2022 and September 2022) were treated with intravesical TXA</p> </li> <ul> <li dir="ltr" aria-level="2"> <p dir="ltr" role="presentation">1 g tranexamic acid in 100 mL NS via Foley catheter</p> </li> <li dir="ltr" aria-level="2"> <p dir="ltr" role="presentation">Clamped Foley for 15 minutes</p> </li> <li dir="ltr" aria-level="2"> <p dir="ltr" role="presentation">Subsequent continuous bladder irrigation, as is standard in most EDs</p> </li> </ul> <li dir="ltr" aria-level="1"> <p dir="ltr" role="presentation">Compared with a cohort of patients visiting the ED for a similar concern between March 2021 and September 2021, the TXA patients had:</p> </li> <ul> <li dir="ltr" aria-level="2"> <p dir="ltr" role="presentation">A shorter median length of stay in the ED (274 min vs. 411 mins, P < 0.001).</p> </li> <li dir="ltr" aria-level="2"> <p dir="ltr" role="presentation">A shorter median duration of Foley catheter placement (145 min vs. 308 mins, P < 0.001)</p> </li> <li dir="ltr" aria-level="2"> <p dir="ltr" role="presentation">Fewer revisits after ED discharge (2.3% vs. 12.3%, P = 0.031)</p> </li> </ul> </ul> <p dir="ltr"><strong>References</strong></p> <p dir="ltr">1. Choi H, Kim DW, Jung E, et al. Impact of intravesical administration of tranexamic acid on gross hematuria in the emergency department: A before-and-after study. Am J Emerg Med. 2023;68:68-72. doi:10.1016/j.ajem.2023.03.020</p> <p dir="ltr"><em>Summarized by Jorge Chalit, OMSII | Edited by Meg Joyce & Jorge Chalit, OMSII</em></p>