Maegele M. Unkritischer Gebrauch von Tranexams\u00e4ure bei Traumapatienten. <\/strong>Der Unfallchirurg 2016; 119: 967\u201372<\/strong><\/p><\/blockquote>\n
Vielmehr zeigten aktuelle Daten, dass unterschiedliche Ph\u00e4notypen der traumatischen Gerinnungsst\u00f6rung best\u00fcnden:<\/p>\n
\n
- den gr\u00f6\u00dfen Part n\u00e4hme demnach die sog. „Shutdown“-Hypo<\/strong>fibrinolyse ein (64% )<\/li>\n
- gefolgt von einer physiologischen<\/strong> Fibrinolyse (18%)<\/li>\n
- und nur die letzte Gruppe zeige tats\u00e4chlich eine Hyper<\/strong>fibrinolyse.<\/li>\n<\/ul>\n
Entsprechend bek\u00e4me die Mehrheit der Traumapatienten TXA ohne Indikation.<\/p>\n
Weltweit laufen derzeit verschiedenen Studien, um die H\u00e4ufigkeit und das Ausma\u00df der traumatischen Hyperfibrinolyse zu erfassen. Bis diese Ergebnisse vorliegen k\u00f6nnte es unter Umst\u00e4nden richtiger sein, die Gabe von TXA von einer Thrombelastographie (ROTEM) im Schockraum abh\u00e4ngig zu machen.<\/p>\n
Beispiel einer TXA-sensitiven Hyperfibrinolyse im ROTEM\u00aebei einem schwerstverletzten Polytraumapatienten mit Sch\u00e4del-Hirn-Beteiligung. Gerinnselzusammenbruch im EXTEM, INTEM und FIBTEM bei erhaltener und insgesamt akzeptabler Gerinnselstabilit\u00e4t im APTEM unter Zugabe von TXA. — (C) SPRINGER, Der Unfallchirurg<\/figcaption><\/figure>\n Als praktikabele Formulierung f\u00fcr die pr\u00e4hospitale Versorgung ist wohl am ehesten der therapeutische Effekt der fr\u00fchen Gabe von TXA beim blutenden Traumapatienten im h\u00e4morrhagischen Schock mit aus Sicht des Notarztes bestehendem Risiko f\u00fcr eine Massivtransfusion<\/strong> belegt.<\/p>\n
\nLiteratur:<\/strong><\/p>\n
\n\n\n\n
- CRASH-2 trial collaborators, Shakur H, Roberts I, Bautista R, Caballero J, Coats T, Dewan Y, El-Sayed H, Gogichaishvili T, Gupta S, Herrera J, Hunt B, Iribhogbe P, Izurieta M, Khamis H, Komolafe E, Marrero MA, Mej\u00eda-Mantilla J, Miranda J, Morales C, Olaomi O, Olldashi F, Perel P, Peto R, Ramana PV, Ravi RR, Yutthakasemsunt S (2010) Effects of tranexamic acid on death, vascular occlusive events, and blood transfusion in trauma patients with significant haemorrhage (CRASH-2): A randomised, placebo- controlled trial. Lancet 376(9734):23\u201332<\/li>\n<\/ul>\n
\n
- \n
\n\nMoore HB, Moore EE, Gonzalez E, Chapman MP, Chin TL, Silliman CC, Banerjee A, Sauaia A (2014) Hyperfibrinolysis, physiologic fibrinolysis, and fibrinolysis shutdown: The spectrum of postinjury fibrinolysis and relevance to antifibrinolytic therapy. J Trauma Acute Care Surg 77(6):811\u2013817<\/p>\n<\/div>\n<\/div>\n<\/li>\n<\/ul>\n<\/div>\n<\/div>\n<\/div>\n
\n
- Morrison J, Dubosse J, Rasmussen T, Midwinter M (2012) Military application of tranexamic acid in trauma emergency resuscitation (MATTERs) study. Arch Surg 147(2):113\u201311<\/li>\n<\/ul>\n
\n
- Cole E, Davenport R, Willet K, Brohi K (2015) Tranexamic acid use in severely injured civilian pa- tients and the effects on outcomes: A prospective cohort study. Ann Surg 262(2):390\u2013394<\/li>\n<\/ul>\n","protected":false},"excerpt":{"rendered":"
Infolge der CRASH-2-Studie und der Darstellung der Ergebnisse dahin gehend, dass der gr\u00f6\u00dfte Effekt auf das Outcome erzielt w\u00fcrde, wenn Tranexams\u00e4ure (TXA) dem blutenden Traumapatienten bereits in der ersten Stunde […]<\/p>\n","protected":false},"author":1,"featured_media":3020,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"__cvm_playback_settings":[],"__cvm_video_id":"","jetpack_post_was_ever_published":false,"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":true,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_publicize_message":"","jetpack_publicize_feature_enabled":true,"jetpack_social_post_already_shared":true,"jetpack_social_options":{"image_generator_settings":{"template":"highway","default_image_id":0,"font":"","enabled":false},"version":2},"_wpas_customize_per_network":false},"categories":[6],"tags":[531,186,688,56,185,184],"class_list":["post-3014","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-trauma","tag-blutstillung","tag-blutung","tag-kritik","tag-polytrauma","tag-tranexamsaeure","tag-txa"],"jetpack_publicize_connections":[],"jetpack_featured_media_url":"https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2016\/11\/TXA-e1763286895643.jpg?fit=324%2C232","jetpack_sharing_enabled":true,"jetpack_shortlink":"https:\/\/wp.me\/p7fR2g-MC","jetpack-related-posts":[{"id":7231,"url":"http:\/\/news-papers.eu\/?p=7231","url_meta":{"origin":3014,"position":0},"title":"TXA \u2013 nicht mit der Gie\u00dfkanne! Teil 1","author":"Michael Bernhard","date":"Mai 17, 2018","format":false,"excerpt":"Es ist mal wieder Zeit\u00a0f\u00fcr eine Serien: Hier nun Teil 1 eines gemeinsamen Beitrages von Dr. Heiko Lier, K\u00f6ln\/Deutschland und PD Dr. J\u00fcrgen Knapp, Bern Schweiz: Vermutlich basierend auf den zwei gro\u00dfen Studien zum Nutzen der Tranexams\u00e4ure (TXA) bei (vermuteter) massiver Blutung beim Trauma-Patienten (CRASH-2 trial) bzw. bei der peripartalen\u2026","rel":"","context":"In "Blutungsmanagement"","block_context":{"text":"Blutungsmanagement","link":"http:\/\/news-papers.eu\/?cat=1210"},"img":{"alt_text":"","src":"https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2018\/05\/Bildschirmfoto-2018-03-31-um-12.50.32-300x197.png?resize=350%2C200","width":350,"height":200},"classes":[]},{"id":20116,"url":"http:\/\/news-papers.eu\/?p=20116","url_meta":{"origin":3014,"position":1},"title":"Kritische Indikation vor wiederholter Applikation von Tranexams\u00e4ure","author":"Bj\u00f6rn Hossfeld","date":"November 17, 2025","format":false,"excerpt":"Seit der CRASH-2-Studie hat sich Tranexams\u00e4ure (TXA) etabliertes Medikament in der Traumaversorgung etabliert. Allerdings wurden die anf\u00e4nglich gro\u00dfz\u00fcgige pr\u00e4hospitale Gabe sp\u00e4testens mit der CALPAT-Studie auf blutende Traumapatientinnen im h\u00e4morrhagischen Schock reduziert, f\u00fcr die in der weiteren Versorgung Transfusionsbedarf angenommen wird. Rezent wurden immer h\u00e4ufiger Bedenken hinsichtlich m\u00f6glicher Komplikationen, insbesondere thromboembolischer\u2026","rel":"","context":"In "Blutungsmanagement"","block_context":{"text":"Blutungsmanagement","link":"http:\/\/news-papers.eu\/?cat=1210"},"img":{"alt_text":"","src":"https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2025\/11\/13049_2025_1512_Fig1_HTML.png-215x300.webp?resize=350%2C200","width":350,"height":200},"classes":[]},{"id":10238,"url":"http:\/\/news-papers.eu\/?p=10238","url_meta":{"origin":3014,"position":2},"title":"Tranexams\u00e4ure, alles klar ? Nein!","author":"Michael Bernhard","date":"Oktober 12, 2019","format":false,"excerpt":"Die Publikation von CRASH-2 [1] f\u00fchrte ab 2010 weltweit zu einer Renaissance eines bereits 1962 [2] erstmals erw\u00e4hnten Medikamentes: Tranexams\u00e4ure (TXA). In der folgenden Dekade wurden rund 3.000 Publikationen zum Thema in PubMed gelistet. W\u00e4hrend in den USA und Australien \/ Neuseeland vereinzelt kritischen Artikel erschienen (z.B. [3]), wurde TXA\u2026","rel":"","context":"In "Blutungsmanagement"","block_context":{"text":"Blutungsmanagement","link":"http:\/\/news-papers.eu\/?cat=1210"},"img":{"alt_text":"TXA","src":"https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2016\/11\/TXA-215x300.jpg?resize=350%2C200","width":350,"height":200},"classes":[]},{"id":9218,"url":"http:\/\/news-papers.eu\/?p=9218","url_meta":{"origin":3014,"position":3},"title":"European bleeding guideline, 5. Auflage – Teil 3","author":"Michael Bernhard","date":"April 23, 2019","format":false,"excerpt":"Spahn DR et al. The European guideline on management of\u00a0major bleeding and coagulopathy\u00a0following trauma: fifth edition.\u00a0Critical Care (2019) 23:98\u00a0(PDF) Kernaussagen (freie \u00dcbersetzung): Vasopressoren und Katecholamine Beim Vorliegen einer lebensbedrohlichen Hypotension empfehlen wir den Einsatz von Vasopressoren und Vasopressoren mit Volumentherapie bis zum Erreichen eines arteriellen Zielblutdrucks.\u00a0(Grade 1C) Wir empfehlen die\u2026","rel":"","context":"In "Blutungsmanagement"","block_context":{"text":"Blutungsmanagement","link":"http:\/\/news-papers.eu\/?cat=1210"},"img":{"alt_text":"","src":"https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2019\/03\/Bildschirmfoto-2019-03-30-um-11.38.16.png?fit=1200%2C433&resize=350%2C200","width":350,"height":200,"srcset":"https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2019\/03\/Bildschirmfoto-2019-03-30-um-11.38.16.png?fit=1200%2C433&resize=350%2C200 1x, https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2019\/03\/Bildschirmfoto-2019-03-30-um-11.38.16.png?fit=1200%2C433&resize=525%2C300 1.5x, https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2019\/03\/Bildschirmfoto-2019-03-30-um-11.38.16.png?fit=1200%2C433&resize=700%2C400 2x, https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2019\/03\/Bildschirmfoto-2019-03-30-um-11.38.16.png?fit=1200%2C433&resize=1050%2C600 3x"},"classes":[]},{"id":12612,"url":"http:\/\/news-papers.eu\/?p=12612","url_meta":{"origin":3014,"position":4},"title":"Der STAAMP trial","author":"Michael Bernhard","date":"Dezember 8, 2020","format":false,"excerpt":"Ein Beitrag von PD Dr. J\u00fcrgen Knapp, Bern\/Schweiz:\u00a0 Lange erwartet waren die Daten einer pragmatischen, doppelt-blinden, randomisierten und Placebo-kontrollierten klinischen Studie zum pr\u00e4hospitalen Einsatz der Tranexams\u00e4ure (TXA) beim Traumapatienten: Guyette FX et al.\u00a0Tranexamic Acid During Prehospital Transport in Patients at Risk for Hemorrhage After Injury: A Double-blind, Placebo-Controlled, Randomized Clinical\u2026","rel":"","context":"In "Blutungsmanagement"","block_context":{"text":"Blutungsmanagement","link":"http:\/\/news-papers.eu\/?cat=1210"},"img":{"alt_text":"","src":"https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2020\/06\/TXA-scaled-e1592730108994.jpg?fit=900%2C1200&resize=350%2C200","width":350,"height":200,"srcset":"https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2020\/06\/TXA-scaled-e1592730108994.jpg?fit=900%2C1200&resize=350%2C200 1x, https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2020\/06\/TXA-scaled-e1592730108994.jpg?fit=900%2C1200&resize=525%2C300 1.5x, https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2020\/06\/TXA-scaled-e1592730108994.jpg?fit=900%2C1200&resize=700%2C400 2x"},"classes":[]},{"id":4641,"url":"http:\/\/news-papers.eu\/?p=4641","url_meta":{"origin":3014,"position":5},"title":"WOMAN trial: TxA bei peripartalen Blutungen","author":"Michael Bernhard","date":"April 30, 2017","format":false,"excerpt":"Ein Beitrag von PD Dr. J\u00fcrgen Knapp aus Bern: Ein sehr sch\u00f6ner und interessanter Beitrag ist mit dem WOMAN trial erschienen: WOMAN Trial Collaborators: Effect of early tranexamic acid administration on mortality, hysterectomy, and other morbidities in women with post-partum haemorrhage (WOMAN): an international, randomised, double-blind, placebo-controlled trial. Lancet 2017.\u2026","rel":"","context":"In "Blutstillung"","block_context":{"text":"Blutstillung","link":"http:\/\/news-papers.eu\/?cat=4"},"img":{"alt_text":"","src":"https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2017\/06\/Txa1.jpg?fit=960%2C717&resize=350%2C200","width":350,"height":200,"srcset":"https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2017\/06\/Txa1.jpg?fit=960%2C717&resize=350%2C200 1x, https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2017\/06\/Txa1.jpg?fit=960%2C717&resize=525%2C300 1.5x, https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2017\/06\/Txa1.jpg?fit=960%2C717&resize=700%2C400 2x"},"classes":[]}],"jetpack_likes_enabled":true,"_links":{"self":[{"href":"http:\/\/news-papers.eu\/index.php?rest_route=\/wp\/v2\/posts\/3014","targetHints":{"allow":["GET"]}}],"collection":[{"href":"http:\/\/news-papers.eu\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"http:\/\/news-papers.eu\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"http:\/\/news-papers.eu\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"http:\/\/news-papers.eu\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=3014"}],"version-history":[{"count":15,"href":"http:\/\/news-papers.eu\/index.php?rest_route=\/wp\/v2\/posts\/3014\/revisions"}],"predecessor-version":[{"id":3109,"href":"http:\/\/news-papers.eu\/index.php?rest_route=\/wp\/v2\/posts\/3014\/revisions\/3109"}],"wp:featuredmedia":[{"embeddable":true,"href":"http:\/\/news-papers.eu\/index.php?rest_route=\/wp\/v2\/media\/3020"}],"wp:attachment":[{"href":"http:\/\/news-papers.eu\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=3014"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"http:\/\/news-papers.eu\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=3014"},{"taxonomy":"post_tag","embeddable":true,"href":"http:\/\/news-papers.eu\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=3014"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}
![\"rotem](\"https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2016\/11\/ROTEM_Hyperfibrinolyse.png?resize=640%2C403\" "\\"\\"")