{"id":7217,"date":"2018-07-03T04:31:33","date_gmt":"2018-07-03T02:31:33","guid":{"rendered":"http:\/\/news-papers.eu\/?p=7217"},"modified":"2018-05-10T21:00:23","modified_gmt":"2018-05-10T19:00:23","slug":"txa-bei-nasenbluten","status":"publish","type":"post","link":"https:\/\/news-papers.eu\/?p=7217","title":{"rendered":"TXA bei Nasenbluten"},"content":{"rendered":"<p><strong><img data-recalc-dims=\"1\" loading=\"lazy\" decoding=\"async\" data-attachment-id=\"6928\" data-permalink=\"https:\/\/news-papers.eu\/?attachment_id=6928\" data-orig-file=\"https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2018\/01\/Nasenbluten-e1515698353970.jpg?fit=1000%2C721&amp;ssl=1\" data-orig-size=\"1000,721\" data-comments-opened=\"1\" data-image-meta=\"{&quot;aperture&quot;:&quot;0&quot;,&quot;credit&quot;:&quot;&quot;,&quot;camera&quot;:&quot;&quot;,&quot;caption&quot;:&quot;&quot;,&quot;created_timestamp&quot;:&quot;0&quot;,&quot;copyright&quot;:&quot;&quot;,&quot;focal_length&quot;:&quot;0&quot;,&quot;iso&quot;:&quot;0&quot;,&quot;shutter_speed&quot;:&quot;0&quot;,&quot;title&quot;:&quot;&quot;,&quot;orientation&quot;:&quot;0&quot;}\" data-image-title=\"Nasenbluten\" data-image-description=\"\" data-image-caption=\"\" data-medium-file=\"https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2018\/01\/Nasenbluten-e1515698353970.jpg?fit=300%2C216&amp;ssl=1\" data-large-file=\"https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2018\/01\/Nasenbluten-e1515698353970.jpg?fit=1024%2C738&amp;ssl=1\" class=\"size-medium wp-image-6928 alignright\" src=\"https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2018\/01\/Nasenbluten.jpg?resize=300%2C216\" alt=\"\" width=\"300\" height=\"216\" \/>Ein Beitrag von PD Dr. J\u00fcrgen Knapp, Bern\/Schweiz:<\/strong><\/p>\n<blockquote><p><strong>Zahed R et al. Topical Tranexamic Acid Compared With Anterior Nasal Packing for Treatment of Epistaxis in Patients Taking Antiplatelet Drugs: Randomized Controlled Trial. Acad Emerg Med 2018; 25:261-6.<\/strong><\/p><\/blockquote>\n<ul>\n<li>randomisiert kontrollierte Studie<\/li>\n<li>2 gro\u00dfe akademische Lehrkrankenh\u00e4user im Iran<\/li>\n<li>Oktober 2015 &#8211; April 2016<\/li>\n<li>Patienten unter Thrombozytenhemmern (Aspirin oder Clopidogrel oder beides) mit erstmalig oder wiederholt aufgetretenem vorderem Nasenbluten, das trotz manueller Kompression mehr als 20 min anh\u00e4lt: n=124<\/li>\n<li>kein traumatisches Nasenbluten, ebenso waren Patienten unter Antikoagulanzien, bekannten heredit\u00e4ren Gerinnungsst\u00f6rungen, Gef\u00e4\u00dfanomalien, INR&gt;1,5, sichtbar blutendem Gef\u00e4\u00df etc. ausgeschlossen<\/li>\n<li>62 Patienten herk\u00f6mmliche Behandlung mit vorderer Nasentamponade (anterior nasal packing, ANP): Tamponade mit Adrenalin (1:100.000) und Lidocain 2% getr\u00e4nkter Baumwoll-Kompresse f\u00fcr 10 min, im Anschluss Tamponade mit Baumwoll-Kompressen (mit Tetrazyklin-Salbe) f\u00fcr 3 Tage<\/li>\n<li>62 Patienten in der TXA-Gruppe: eine 15 cm lange in der handels\u00fcblichen Form der Tranexams\u00e4ure (500 mg\/5 ml) getr\u00e4nkte Baumwoll-Kompresse in das betroffene Nasenloch. Entfernung der Kompresse nach Sistieren der Blutung.<\/li>\n<li>Die Blutung kam in der TXA-Gruppe in 73% und in der ANP-Gruppe in 29% innerhalb 10 min zum Stehen, p&lt;0,001<\/li>\n<li>im Median dauerte es 10 min in der TXA-Gruppe und 15 min in der ANP-Gruppe bis die Blutung stand, p&lt;0,001<\/li>\n<li>innerhalb von 1 Woche kam es in 5 % der Patienten der TXA-Grippe und 21% der Patienten der ANP-Gruppe zu einer erneuten Blutung, p=0,007<\/li>\n<li>97% der Patienten der TXA-Gruppe konnten innerhalb von 2 h aus der Notaufnahme entlassen werden, dagegen nur 13 % der Patienten, die mit einer herk\u00f6mmlichen Nasentamponade behandelt wurden.<\/li>\n<\/ul>\n<blockquote>\n<p style=\"text-align: justify;\"><strong>Fazit f\u00fcr die Praxis: die topische Anwendung der TXA scheint bei Nasenbluten unter Einnahme von Thrombozytenhemmern eine effektivere und vermutlich f\u00fcr den Patienten die angenehmere Methode der Blutstillung zu sein als die herk\u00f6mmliche vordere Nasentamponade.<\/strong><\/p>\n<\/blockquote>\n<hr \/>\n<p><strong><a href=\"https:\/\/twitter.com\/news_papers_eu?refsrc=email&amp;s=11\" target=\"_blank\" rel=\"noopener noreferrer\">News-Papers.eu auf TWITTER<\/a>\u00a0 \u00a0 \u00a0 \u00a0\u00a0<a href=\"http:\/\/news-papers.eu\/follow\" target=\"_blank\" rel=\"noopener noreferrer\">Follow news-papers.eu<\/a><\/strong><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Ein Beitrag von PD Dr. J\u00fcrgen Knapp, Bern\/Schweiz: Zahed R et al. Topical Tranexamic Acid Compared With Anterior Nasal Packing for Treatment of Epistaxis in Patients Taking Antiplatelet Drugs: Randomized [&hellip;]<\/p>\n","protected":false},"author":2,"featured_media":6928,"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":false,"_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}},"categories":[1210],"tags":[],"class_list":["post-7217","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-blutungsmanagement"],"jetpack_publicize_connections":[],"jetpack_featured_media_url":"https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2018\/01\/Nasenbluten-e1515698353970.jpg?fit=1000%2C721&ssl=1","jetpack_sharing_enabled":true,"jetpack_shortlink":"https:\/\/wp.me\/p7fR2g-1Sp","jetpack-related-posts":[{"id":10611,"url":"https:\/\/news-papers.eu\/?p=10611","url_meta":{"origin":7217,"position":0},"title":"TXA bei Nasenbluten?","author":"Michael Bernhard","date":"Dezember 16, 2019","format":false,"excerpt":"Ein Beitrag von PD Dr. J\u00fcrgen Knapp, Bern\/Schweiz: \u00dcber den Nutzen der topischen Anwendung von Tranexams\u00e4ure (TXA) bei Nasenbluten von Patienten, die unter Therapie mit Thrombozytenhemmern stehen, haben wir bereits in einem fr\u00fcheren Blog-Beitrag berichtet (LINK\u00a0und LINK). Aktuell wurde nun in Annals of Emergency Medicine (einem der hochrangigsten notfallmedizinischen Journals)\u2026","rel":"","context":"In &quot;Blutungsmanagement&quot;","block_context":{"text":"Blutungsmanagement","link":"https:\/\/news-papers.eu\/?cat=1210"},"img":{"alt_text":"","src":"https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2019\/12\/Nasenbluten-e1575921321110.jpg?fit=600%2C433&ssl=1&resize=350%2C200","width":350,"height":200,"srcset":"https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2019\/12\/Nasenbluten-e1575921321110.jpg?fit=600%2C433&ssl=1&resize=350%2C200 1x, https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2019\/12\/Nasenbluten-e1575921321110.jpg?fit=600%2C433&ssl=1&resize=525%2C300 1.5x"},"classes":[]},{"id":6927,"url":"https:\/\/news-papers.eu\/?p=6927","url_meta":{"origin":7217,"position":1},"title":"Epistaxis, und was tun?","author":"Michael Bernhard","date":"M\u00e4rz 24, 2018","format":false,"excerpt":"Einen interessanten Artikel zu Nasenbluten liegt nun von Beck et al. aus dem Deutschen \u00c4rzteblatt vor: Beck R, et al.\u00a0Therapiekonzepte der Epistaxis in Praxis und Klinik.Dtsch Arztebl Int 2018; 115(1-2): 12-22; DOI: 10.3238\/arztebl.2018.0012 (PDF) News-Papers.eu auf TWITTER\u00a0 \u00a0 \u00a0 \u00a0\u00a0Follow news-papers.eu","rel":"","context":"In &quot;Blutstillung&quot;","block_context":{"text":"Blutstillung","link":"https:\/\/news-papers.eu\/?cat=4"},"img":{"alt_text":"","src":"https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2018\/01\/Nasenbluten-e1515698353970.jpg?fit=1000%2C721&ssl=1&resize=350%2C200","width":350,"height":200,"srcset":"https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2018\/01\/Nasenbluten-e1515698353970.jpg?fit=1000%2C721&ssl=1&resize=350%2C200 1x, https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2018\/01\/Nasenbluten-e1515698353970.jpg?fit=1000%2C721&ssl=1&resize=525%2C300 1.5x, https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2018\/01\/Nasenbluten-e1515698353970.jpg?fit=1000%2C721&ssl=1&resize=700%2C400 2x"},"classes":[]},{"id":6624,"url":"https:\/\/news-papers.eu\/?p=6624","url_meta":{"origin":7217,"position":2},"title":"Hypertensiver Notfall &#8211; und jetzt ?","author":"Michael Bernhard","date":"Januar 6, 2018","format":false,"excerpt":"T\u00e4glich werden Notfallmediziner allerorts mit dem hypertensiven Notfall konfrontiert. Sozusagen ein h\u00e4ufig auftretender Notfall. Aber was machen? Prof. Gerd B\u00f6nner aus Freiburg hat hierzu eine exzellente \u00dcbersicht publiziert: B\u00f6nner G. Der hypertensive Notfall. DMW 2017; 142: 1437-1445 Unterschieden werden: 1.Krisenhafter Blutdruckanstieg\/Hypertensive Krise bedrohliche Symptome bei einer unkomplizierten Hypertonie unspezifischen Symptome:\u2026","rel":"","context":"In &quot;Kardiovaskul\u00e4rer Notfall&quot;","block_context":{"text":"Kardiovaskul\u00e4rer Notfall","link":"https:\/\/news-papers.eu\/?cat=1079"},"img":{"alt_text":"","src":"https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2017\/11\/Blutdruck-300x200.jpg?resize=350%2C200","width":350,"height":200},"classes":[]},{"id":13550,"url":"https:\/\/news-papers.eu\/?p=13550","url_meta":{"origin":7217,"position":3},"title":"Sturz unter oraler Antikoagulation: DOACs oder Marcumar schlimmer?","author":"Michael Bernhard","date":"Mai 16, 2021","format":false,"excerpt":"St\u00fcrze aus dem Stand sind bei \u00e4lteren Menschen h\u00e4ufig und mit einem signifikanten Blutungsrisiko verbunden. M\u00fcller M, et al. Falls in ED patients: do elderly patients on direct oral anticoagulants bleed less than those on vitamin K antagonists? Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine (2021) 29:56 (PDF) In\u2026","rel":"","context":"In &quot;Trauma&quot;","block_context":{"text":"Trauma","link":"https:\/\/news-papers.eu\/?cat=6"},"img":{"alt_text":"Sturz","src":"https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2021\/04\/metaphor-1209691_1920-e1617726954910.jpg?fit=1000%2C675&ssl=1&resize=350%2C200","width":350,"height":200,"srcset":"https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2021\/04\/metaphor-1209691_1920-e1617726954910.jpg?fit=1000%2C675&ssl=1&resize=350%2C200 1x, https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2021\/04\/metaphor-1209691_1920-e1617726954910.jpg?fit=1000%2C675&ssl=1&resize=525%2C300 1.5x, https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2021\/04\/metaphor-1209691_1920-e1617726954910.jpg?fit=1000%2C675&ssl=1&resize=700%2C400 2x"},"classes":[]},{"id":13875,"url":"https:\/\/news-papers.eu\/?p=13875","url_meta":{"origin":7217,"position":4},"title":"Behandlung spontaner intrazerebraler Blutungen","author":"Michael Bernhard","date":"Juni 27, 2021","format":false,"excerpt":"Die aktuelle Leitlinie f\u00fcr spontane intrazerebrale Blutungen ist auf der AWMF-Hompage publiziert worden: Link: https:\/\/www.awmf.org\/uploads\/tx_szleitlinien\/030-002l_S2k_Behandlung-von-spontanen-intrazerebralen-Blutungen_2021-06.pdf Was ist neu ? Blutdruck Bei Patienten mit akuter spontaner intrazerebraler Blutung sollte der systolische Blutdruck mo\u0308glichst innerhalb von 2 Stunden nach Beginn der Blutung auf Werte kleiner oder gleich 140 mmHg, jedoch nicht unter\u2026","rel":"","context":"In &quot;Neurologischer Notfall&quot;","block_context":{"text":"Neurologischer Notfall","link":"https:\/\/news-papers.eu\/?cat=7"},"img":{"alt_text":"","src":"https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2021\/06\/Bildschirmfoto-2021-06-19-um-15.04.20-e1624107873554.png?fit=500%2C264&ssl=1&resize=350%2C200","width":350,"height":200},"classes":[]},{"id":1056,"url":"https:\/\/news-papers.eu\/?p=1056","url_meta":{"origin":7217,"position":5},"title":"S3 Leitlinie: Ambulant erworbene Pneumonie: Die Fakts Teil 3","author":"Michael Bernhard","date":"April 20, 2016","format":false,"excerpt":"Nach Teil 1&2 der Fakts zur S3 Leitlinien\u00a0\"Ambulant erworbenen Pneumonie\"\u00a0geht es nun im 3. Teil\u00a0um\u00a0konkrete initiale Massnahmen: Die Letalit\u00e4t der ambulant erworbenen Pneumonie wird h\u00e4ufig untersch\u00e4tzt, insbesondere bei der Entstehung von Organversagen im weiteren Verlauf (Tag 3-7). Patienten die \u22651 Minorkriterien (nach ATS\/IDSA) aufweisen sollten intensiv \u00fcberwacht werden. D.h. es\u2026","rel":"","context":"In &quot;Ambulant erworbene Pneumonie&quot;","block_context":{"text":"Ambulant erworbene Pneumonie","link":"https:\/\/news-papers.eu\/?cat=146"},"img":{"alt_text":"","src":"https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2016\/03\/Pneumoni3.png?fit=958%2C1024&ssl=1&resize=350%2C200","width":350,"height":200,"srcset":"https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2016\/03\/Pneumoni3.png?fit=958%2C1024&ssl=1&resize=350%2C200 1x, https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2016\/03\/Pneumoni3.png?fit=958%2C1024&ssl=1&resize=525%2C300 1.5x, https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2016\/03\/Pneumoni3.png?fit=958%2C1024&ssl=1&resize=700%2C400 2x"},"classes":[]}],"jetpack_likes_enabled":true,"_links":{"self":[{"href":"https:\/\/news-papers.eu\/index.php?rest_route=\/wp\/v2\/posts\/7217","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/news-papers.eu\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/news-papers.eu\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/news-papers.eu\/index.php?rest_route=\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/news-papers.eu\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=7217"}],"version-history":[{"count":4,"href":"https:\/\/news-papers.eu\/index.php?rest_route=\/wp\/v2\/posts\/7217\/revisions"}],"predecessor-version":[{"id":7527,"href":"https:\/\/news-papers.eu\/index.php?rest_route=\/wp\/v2\/posts\/7217\/revisions\/7527"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/news-papers.eu\/index.php?rest_route=\/wp\/v2\/media\/6928"}],"wp:attachment":[{"href":"https:\/\/news-papers.eu\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=7217"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/news-papers.eu\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=7217"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/news-papers.eu\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=7217"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}