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Comparing Adrenaline with Tranexamic Acid to Control Acute Endobronchial
Bleeding: A Randomized Controlled Trial
#MMPMID28360438
Fekri MS
; Hashemi-Bajgani SM
; Shafahi A
; Zarshenas R
Iran J Med Sci
2017[Mar]; 42
(2
): 129-135
PMID28360438
show ga
BACKGROUND: Hemoptysis occurs due to either pulmonary diseases or bronchoscopy
interventions. The aim of the present study was to compare the efficacy of the
endobronchial instillation of adrenaline with that of tranexamic acid. METHODS:
Fifty patients were randomly selected as 2 double-blinded sample groups (n=25).
In these patients, bleeding could not be controlled with cold saline lavage
during bronchoscopy and they, therefore, required prescription of another
medicine. Adrenaline (1 mg) in one group and tranexamic acid (500 mg) in the
other group were diluted in 20 mL of normal saline and instilled through the
bronchoscope. This technique was repeated 3 times at 90-second intervals, if
necessary. In the case of persistent bleeding, 90 seconds after the last dose, a
second medicine was given for bleeding control. Observation of clot through the
bronchoscope meant that the bleeding had stopped. The efficacy of tranexamic acid
and adrenaline was evaluated and then compared using the Mann-Whitney test.
RESULTS: The time of bleeding control had no significant difference between
tranexamic acid and adrenaline (P=0.908). Another analysis was done to evaluate
bleeding control with a second medicine; the results showed that 1 (4%) patient
in the tranexamic acid and 8 (32%) in the adrenaline group needed the second
medicine and there was no significant difference between the 2 groups (P=0.609).
CONCLUSION: Our results suggested that tranexamic acid by endobronchial
instillation was as efficient as adrenaline in controlling hemoptysis and
required less frequent use of a second medicine. Trial Registration Number:
IRCT2014120220188.