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Module 4: Thoracic Injuries

Segment 12: Traumatic Bleeding

References labeled PEDS contain a pediatric element or primary focus.

Topic: Transfusion, bleeding, coagulopathies

  • Anand T, Shin H, Ratnasekera A, et al. Rethinking balanced resuscitation in trauma. J Clin Med. 2025;14(6) doi: 10.3390/jcm14062111 https://pubmed.ncbi.nlm.nih.gov/40142918/.
  • Barletta JF, Lim H, Sucher JF, et al. Tranexamic acid in patients with traumatic brain injury: Is there benefit in patients with fibrinolytic shutdown? J Trauma Acute Care Surg. 2026;doi: 10.1097/ta.0000000000005066 https://pubmed.ncbi.nlm.nih.gov/42441910/.
  • Bialkower M, McLiesh H, Manderson CA, et al. Rapid, hand-held paper diagnostic for measuring fibrinogen concentration in blood. Anal Chim Acta. 2020;1102:72-83. doi: 10.1016/j.aca.2019.12.046 https://pubmed.ncbi.nlm.nih.gov/32043998/.
  • Bonanno F. Early coagulopathy in trauma and major bleeding: Is it time to challenge the dogma? Trauma. 2021;0(0):1-4. doi: 10.1177/1460408621993752 https://journals.sagepub.com/doi/pdf/10.1177/1460408621993752.
  • Buzzard L, Schreiber M. Trauma-induced coagulopathy: What you need to know. J Trauma Acute Care Surg. 2024;96(2):179-185. doi: 10.1097/ta.0000000000004170 https://pubmed.ncbi.nlm.nih.gov/37828662/.
  • Ciaraglia A, Myers JC, Braverman M, et al. Transfusion-related cost comparison of trauma patients receiving whole blood versus component therapy. J Trauma Acute Care Surg. 2023;95(1):62-68. doi: 10.1097/ta.0000000000003933 https://pubmed.ncbi.nlm.nih.gov/36973870/.
  • Costantini TW, Kornblith LZ, Pritts T, et al. The intersection of coagulation activation and inflammation after injury: What you need to know. J Trauma Acute Care Surg. 2024;96(3):347-356. doi: 10.1097/ta.0000000000004190 https://pubmed.ncbi.nlm.nih.gov/37962222/.
  • Duclos G, Seube Remy PA, Willig M, et al. Sonorheometry to detect traumatic induced coagulopathy during initial management of trauma patients: an observational, multi-center study. Scand J Trauma Resusc Emerg Med. 2026;34(1) doi: 10.1186/s13049-026-01610-8 https://pubmed.ncbi.nlm.nih.gov/41987276/.
  • Duque P, Calvo A, Lockie C, et al. Pathophysiology of trauma-induced coagulopathy. Transfus Med Rev. 2021;35(4):80-86. doi: 10.1016/j.tmrv.2021.07.004 https://pubmed.ncbi.nlm.nih.gov/34610877/.
  • Durkin ZJ, Whebell SF, Wullschleger M, et al. Platelet dysfunction in trauma: a sub study of the FEISTY pilot trial analysing whole blood aggregometry data. Injury. 2025;56(8):112468. doi: 10.1016/j.injury.2025.112468 https://pubmed.ncbi.nlm.nih.gov/40479939/.
  • Fields AT, Matthay ZA, Nunez-Garcia B, et al. Good platelets gone bad: The effects of trauma patient plasma on healthy platelet aggregation. Shock. 2021;55(2):189-197. doi: 10.1097/shk.0000000000001622 https://pubmed.ncbi.nlm.nih.gov/32694397/.
  • Furman LM, Bizri N, Feeney EV, et al. Unique pattern of coagulopathy among patients with severe traumatic brain injury: A principal component analysis of hemorrhagic shock trials. Crit Care Med. 2026;doi: 10.1097/ccm.0000000000007005 https://pubmed.ncbi.nlm.nih.gov/41504542/.
  • Gallagher LT, LaCroix I, Fields AT, et al. Platelet releasates mitigate the endotheliopathy of trauma. J Trauma Acute Care Surg. 2024;97(5):738-746. doi: 10.1097/ta.0000000000004342 https://pubmed.ncbi.nlm.nih.gov/38764145/.
  • Ho VK, Wong J, Martinez A, et al. Trauma-induced coagulopathy: Mechanisms and clinical management. Ann Acad Med Singap. 2022;51(1):40-48. doi: 10.47102/annals-acadmedsg.2020381 https://pubmed.ncbi.nlm.nih.gov/35091729/.
  • Holcomb JB, Minei KM, Scerbo ML, et al. Admission rapid thrombelastography can replace conventional coagulation tests in the emergency department: experience with 1974 consecutive trauma patients. Ann Surg. 2012;256(3):476-86. doi: 10.1097/SLA.0b013e3182658180 https://pubmed.ncbi.nlm.nih.gov/22868371/.
  • Itagaki Y, Hayakawa M, Takahashi Y, et al. The efficacy of coagulation factor concentrates in the management of patients with trauma-induced coagulopathy: a systematic review and meta-analysis. Shock. 2025;63(5):695-705. doi: 10.1097/shk.0000000000002534 https://pubmed.ncbi.nlm.nih.gov/39715048/.
  • Itagaki Y, Hayakawa M, Takahashi Y, et al. Treatments for trauma-induced coagulopathy: Protocol for a systematic review and meta-analysis. JMIR Res Protoc. 2023;12:e49582. doi: 10.2196/49582 https://pubmed.ncbi.nlm.nih.gov/38079205/.
  • Kleinveld DJB, Hamada SR, Sandroni C. Trauma-induced coagulopathy. Intensive Care Med. 2022;doi: 10.1007/s00134-022-06834-7 https://pubmed.ncbi.nlm.nih.gov/35925321/.
  • Koons NJ, Owens GA, Parsons DL, et al. Combat medic testing of a novel monitoring capability for early detection of hemorrhage. J Trauma Acute Care Surg. 2020;doi: 10.1097/ta.0000000000002649 https://pubmed.ncbi.nlm.nih.gov/32118826/.
  • Kornblith LZ, Moore HB, Cohen MJ. Trauma-induced coagulopathy: The past, present, and future. J Thromb Haemost. 2019;17(6):852-862. doi: 10.1111/jth.14450 https://pubmed.ncbi.nlm.nih.gov/30985957/.
  • Kwon J, Kang BH. Hemostatic resuscitation in patients with trauma-induced coagulopathy: a narrative review. Acute Crit Care. 2026;41(1):47-57. doi: 10.4266/acc.003525 https://pubmed.ncbi.nlm.nih.gov/41834633/.
  • Lee JH, Ward KR. Blood failure: traumatic hemorrhage and the interconnections between oxygen debt, endotheliopathy, and coagulopathy. Clin Exp Emerg Med. 2024;11(1):9-21. doi: 10.15441/ceem.23.127 https://pubmed.ncbi.nlm.nih.gov/38018069/.
  • Maginot ER, Moore HB, Moore EE, et al. Change in novel plasmin activated clotting time assay predicts hyperfibrinolysis, massive transfusion, and mortality in trauma in under 3 minutes. Am J Surg. 2025;250:116476. doi: 10.1016/j.amjsurg.2025.116476 https://pubmed.ncbi.nlm.nih.gov/40517530/.
  • Malkin M, Nevo A, Brundage SI, et al. Effectiveness and safety of whole blood compared to balanced blood components in resuscitation of hemorrhaging trauma patients - A systematic review. Injury. 2021;52(2):182-188. doi: 10.1016/j.injury.2020.10.095 https://pubmed.ncbi.nlm.nih.gov/33160609/.
  • Moore EE, Moore HB, Kornblith LZ, et al. Trauma-induced coagulopathy. Nat Rev Dis Primers. 2021;7(1):30. doi: 10.1038/s41572-021-00264-3 https://pubmed.ncbi.nlm.nih.gov/33927200/.
  • Murphy S, Russell A, Meaders D, et al. Transfusion of whole blood is not associated with increased rate of hemolytic transfusion reaction. Mil Med. 2025;190(9-10):e1946-e1950. doi: 10.1093/milmed/usaf080 https://pubmed.ncbi.nlm.nih.gov/40105943/.
  • Omori K, Wada T. Traumatic disseminated intravascular coagulation: a narrative review of modern concepts in pathophysiology, diagnosis, and management. J Thromb Haemost. 2026;24(8):2699-2712. doi: 10.1016/j.jtha.2026.04.038 https://pubmed.ncbi.nlm.nih.gov/42155694/.
  • Omori K, Wada T. Traumatic disseminated intravascular coagulation: a narrative review of modern concepts in pathophysiology, diagnosis, and management. J Thromb Haemost. 2026;24(8):2699-2712. doi: 10.1016/j.jtha.2026.04.038 https://pubmed.ncbi.nlm.nih.gov/42155694/.
  • Raghavan N, Patel M, Cotton BA, et al. Estrogen as a therapeutic agent: Targeting endotheliopathy and coagulopathy in trauma. Transfusion. 2026;doi: 10.1111/trf.70107 https://pubmed.ncbi.nlm.nih.gov/41700516/.
  • Reed CR, Curry N, Juffermans NP, et al. Hemostatic abnormalities after trauma resuscitation: challenges and strategies in caring for the critically injured patient. Ann Intensive Care. 2025;15(1):163. doi: 10.1186/s13613-025-01587-0 https://pubmed.ncbi.nlm.nih.gov/41107643/.
  • Riccardi J, Robles AJ, Ross JT, et al. Traumatic inflammatory-coagulation coactivation occurs early after injury and impacts mortality. Crit Care Med. 2026;doi: 10.1097/ccm.0000000000007224 https://pubmed.ncbi.nlm.nih.gov/42206924/.
  • Ross JT, Robles AJ, Barnes A, et al. Elevated cell-free hemoglobin: A novel early biomarker following traumatic injury. J Trauma Acute Care Surg. 2025;98(3):378-384. doi: 10.1097/ta.0000000000004543 https://pubmed.ncbi.nlm.nih.gov/39722178/.
  • Sabouri M, Vahidian M, Sourani A, et al. Efficacy and safety of fibrinogen administration in acute post-traumatic hypofibrinogenemia in isolated severe traumatic brain injury: A randomized clinical trial. J Clin Neurosci. 2022;101:204-211. doi: 10.1016/j.jocn.2022.05.016 https://pubmed.ncbi.nlm.nih.gov/35642832/.
  • Samuels JM, Moore EE, Silliman CC, et al. Severe traumatic brain injury is associated with a unique coagulopathy phenotype. J Trauma Acute Care Surg. 2019;86(4):686-693. doi: 10.1097/ta.0000000000002173 https://pubmed.ncbi.nlm.nih.gov/30601456/.
  • Savioli G, Ceresa IF, Caneva L, et al. Trauma-induced coagulopathy: Overview of an emerging medical problem from pathophysiology to outcomes. Medicines (Basel). 2021;8(4) doi: 10.3390/medicines8040016 https://pubmed.ncbi.nlm.nih.gov/33805197/.
  • Spahn DR, Bouillon B, Cerny V, et al. The European guideline on management of major bleeding and coagulopathy following trauma: fifth edition. Crit Care. 2019;23(1):98. doi: 10.1186/s13054-019-2347-3 https://pubmed.ncbi.nlm.nih.gov/30917843/.
  • Sugimoto M, Takayama W, Wada T, et al. Trauma-specific revision of the Japanese Association for Acute Medicine disseminated intravascular coagulation criteria improves outcome prediction in severely injured patients. J Trauma Acute Care Surg. 2026;doi: 10.1097/ta.0000000000004914 https://pubmed.ncbi.nlm.nih.gov/41636725/.
  • Taeuber I, Weibel S, Herrmann E, et al. Association of intravenous tranexamic acid with thromboembolic events and mortality: A systematic review, meta-analysis, and meta-regression. JAMA Surg. 2021;156(6):e210884. doi: 10.1001/jamasurg.2021.0884 https://pubmed.ncbi.nlm.nih.gov/33851983/.
  • Thielen O, Erickson C, Stocker B, et al. Thromboinflammatory mediators produced by hyperfibrinolysis following injury. J Trauma Acute Care Surg. 2026;100(3):460-468. doi: 10.1097/ta.0000000000004792 https://pubmed.ncbi.nlm.nih.gov/41489548/.
  • Vulliamy P, Kornblith LZ, Kutcher ME, et al. Alterations in platelet behavior after major trauma: adaptive or maladaptive? Platelets. 2021;32(3):295-304. doi: 10.1080/09537104.2020.1718633 https://pubmed.ncbi.nlm.nih.gov/31986948/.
  • Wang PC, Chen KE, Lin HA, et al. Fibrinogen as an early predictor of acute organ dysfunction in pelvic fractures. Injury. 2026;57(2):112970. doi: 10.1016/j.injury.2025.112970 https://pubmed.ncbi.nlm.nih.gov/41418385/.
  • Winearls J, Ady B, Balogh ZJ, et al. Fibrinogen Early In Severe Trauma studY II (FEISTY II): study protocol for a randomised clinical trial of fibrinogen concentrate vs cryoprecipitate in traumatic haemorrhage in Australia and New Zealand. Trials. 2026;doi: 10.1186/s13063-026-09950-7 https://doi.org/10.1186/s13063-026-09950-7.

Topic: Viscoelastic and platelet monitoring

  • Baksaas-Aasen K, Gall LS, Stensballe J, et al. Viscoelastic haemostatic assay augmented protocols for major trauma haemorrhage (ITACTIC): A randomized, controlled trial. Intensive Care Med. 2021;47(1):49-59. doi: 10.1007/s00134-020-06266-1 https://pubmed.ncbi.nlm.nih.gov/33048195/.
  • Baksaas-Aasen K, Van Dieren S, Balvers K, et al. Data-driven development of ROTEM and TEG algorithms for the management of trauma hemorrhage: A prospective observational multicenter study. Ann Surg. 2019;270(6):1178-1185. doi: 10.1097/sla.0000000000002825 https://pubmed.ncbi.nlm.nih.gov/29794847/.
  • Brill JB, Brenner M, Duchesne J, et al. The role of TEG and ROTEM in damage control resuscitation. Shock. 2021;56(1S):52-61. doi: 10.1097/shk.0000000000001686 https://pubmed.ncbi.nlm.nih.gov/33769424/.
  • Brito AMP, Schreiber MA. Precision hemostasis: how viscoelastic testing guides real-time decision-making in trauma. Trauma Surg Acute Care Open. 2026;11(Suppl 1):e002241. doi: 10.1136/tsaco-2026-002241 https://pubmed.ncbi.nlm.nih.gov/42094753/.
  • Bunch CM, Walsh MM, Moore EE, et al. Needle of death thromboelastography tracings in severely bleeding trauma patients: A novel predictor of hemorrhagic blood failure and futile resuscitation? Acad Emerg Med. 2025;doi: 10.1111/acem.70192 https://pubmed.ncbi.nlm.nih.gov/41199476/.
  • Cochrane C, Chinna S, Um JY, et al. Site-of-care viscoelastic assay in major trauma improves outcomes and is cost neutral compared with standard coagulation tests. Diagnostics (Basel). 2020;10(7) doi: 10.3390/diagnostics10070486 https://pubmed.ncbi.nlm.nih.gov/32708960/.
  • Coggins AR, Nguyen VDD, Pasalic L, et al. Utility of point of care viscoelastic haemostatic assays for trauma patients in the emergency department. Scand J Trauma Resusc Emerg Med. 2025;33(1):68. doi: 10.1186/s13049-025-01388-1 https://pubmed.ncbi.nlm.nih.gov/40275305/.
  • Durkin ZJ, Whebell SF, Wullschleger M, et al. Platelet dysfunction in trauma: A substudy of the FEISTY pilot trial analyzing whole blood aggregometry data. Injury. 2025;doi: 10.1016/j.injury.2025.112468 https://pubmed.ncbi.nlm.nih.gov/40479939/.
  • Gonzalez E, Moore EE, Moore HB. Management of trauma-induced coagulopathy with thrombelastography. Crit Care Clin. 2017;33(1):119-134. doi: 10.1016/j.ccc.2016.09.002 https://pubmed.ncbi.nlm.nih.gov/27894492/.
  • Kvisselgaard AD, Wolthers SA, Wikkelsø A, et al. Rapid update and revision of: Thromboelastography or rotational thromboelastometry guided algorithms in bleeding patients—an updated systematic review with meta-analysis and trial sequential analysis. Acta Anaesthesiol Scand. 2025;69(10):e70127. doi: 10.1111/aas.70127 https://pubmed.ncbi.nlm.nih.gov/41004381/.
  • Kvisselgaard AD, Wolthers SA, Wikkelsø A, et al. Thromboelastography or rotational thromboelastometry guided algorithms in bleeding patients: An updated systematic review with meta-analysis and trial sequential analysis. Acta Anaesthesiol Scand. 2025;69(1):e14558. doi: 10.1111/aas.14558 https://pubmed.ncbi.nlm.nih.gov/39623709/.
  • Lier H, Goossen K, Kugler CM, et al. Inhospital coagulation management and fluid replacement therapy in patients with multiple and/or severe injuries - a systematic review and clinical practice guideline update. Eur J Trauma Emerg Surg. 2025;51(1):240. doi: 10.1007/s00068-025-02919-2 https://pubmed.ncbi.nlm.nih.gov/40576680/.
  • Moore EE, Moore HB, Kornblith LZ, et al. Trauma-induced coagulopathy. Nat Rev Dis Primers. 2022;7(1):30. doi: 10.1038/s41572-021-00264-3. https://pubmed.ncbi.nlm.nih.gov/33927200/.
  • Natalini D, Xhemalaj R, Carelli S. Viscoelastic hemostatic assays in the management of trauma-induced coagulopathy: A clinical update. J Clin Med. 2025;15(1) doi: 10.3390/jcm15010012 https://pubmed.ncbi.nlm.nih.gov/41517266/.
  • Rech MA, Gilbert BW, Nei S, et al. The clot thickens: How to use viscoelastic testing in critical illness. J Ame Col Clinical Pharmacy. 2023;6(8):954-963. doi: 10.1002/jac5.1829 https://accpjournals.onlinelibrary.wiley.com/doi/epdf/10.1002/jaCrit Carec5.1829.
  • Sarani B, Callum J, Neal MD, et al. Goal-directed transfusion algorithm for trauma patients with severe hemorrhage using TEG 6S: Results of a Delphi consensus survey and expert panel recommendations. J Trauma Acute Care Surg. 2025;doi: 10.1097/ta.0000000000004606 https://pubmed.ncbi.nlm.nih.gov/40170216/.
  • Spagnolello O, J Reed M, Dauncey S, et al. Introduction of a ROTEM protocol for the management of trauma-induced coagulopathy. Trauma. 2021;23(4):308-321. doi: 10.1177/1460408620957919 https://journals.sagepub.com/doi/10.1177/1460408620957919.
  • Subramanian M, Kaplan LJ, Cannon JW. Thromboelastography-guided resuscitation of the trauma patient. JAMA Surg. 2019;doi: 10.1001/jamasurg.2019.3136 https://pubmed.ncbi.nlm.nih.gov/31596452/.
  • Vollmer NJ, Leshko NA, Wilson CS, Jr, et al. A review of thromboelastography for nurses. Crit Care Nurse. 2023;43(3):29-37. doi: 10.4037/ccn2023371 https://pubmed.ncbi.nlm.nih.gov/37257875/.
  • Wan P, Geng Y, Su L, et al. Managing coagulation using the Sonoclot analyzer in patients with disseminated intravascular coagulation. Am J Crit Care. 2025;34(3):194-207. doi: 10.4037/ajcc2025807 https://pubmed.ncbi.nlm.nih.gov/40307183/.
  • Whitton TP, Healy WJ. Review of thromboelastography (TEG): Medical and surgical applications. Ther Adv Pulm Crit Care Med. 2023;18:29768675231208426. doi: 10.1177/29768675231208426 https://pubmed.ncbi.nlm.nih.gov/38107072/.

Topic: Pro-clot agents

  • Acharya P, Amin A, Nallamotu S, et al. Prehospital tranexamic acid in trauma patients: a systematic review and meta-analysis of randomized controlled trials. Front Med (Lausanne). 2023;10:1284016. doi: 10.3389/fmed.2023.1284016 https://pubmed.ncbi.nlm.nih.gov/37928456/.
  • Ageron FX, Shakur-Still H, Roberts I. Effects of tranexamic acid treatment in severely and non-severely injured trauma patients. Transfusion. 2022;doi: 10.1111/trf.16954 https://pubmed.ncbi.nlm.nih.gov/35748686/.
  • Alhenaki AM, Ali AS, Kadir B, et al. Pre-hospital administration of tranexamic acid in trauma patients: A systematic review and meta-analysis. Trauma. 2021;24(3):185-194. doi: 10.1177/14604086211001163 https://doi.org/10.1177/14604086211001163.
  • Ali A, Gruen RL, Bernard SA, et al. Tranexamic acid timing and mortality impact after trauma. Ann Emerg Med. 2026;87(1):83-89. doi: 10.1016/j.annemergmed.2025.06.609 https://pubmed.ncbi.nlm.nih.gov/40751727/.
  • Almuwallad A, Cole E, Ross J, et al. The impact of pre-hospital TXA on mortality among bleeding trauma patients: A systematic review and meta-analysis. J Trauma Acute Care Surg. 2021;doi: 10.1097/ta.0000000000003120 https://pubmed.ncbi.nlm.nih.gov/33605702/.
  • Alwakeal A, Maas MB, Naidech AM, et al. Fixed- versus variable-dose prothrombin complex concentrate for the emergent reversal of vitamin K antagonists: A systematic review and meta-analysis. Crit Care Med. 2024;52(5):811-820. doi: 10.1097/ccm.0000000000006212 https://pubmed.ncbi.nlm.nih.gov/38353592/.
  • Barmettler N, Maginot ER, Moore EE, et al. Tranexamic acid bolus plus drip paradoxically increases complement activation: A PATCH trial secondary study. J Trauma Acute Care Surg. 2026;100(5):747-753. doi: 10.1097/ta.0000000000004896 https://pubmed.ncbi.nlm.nih.gov/41632465/.
  • Barquero López M, Martínez Cabañero J, Muñoz Valencia A, et al. Dynamic use of fibrinogen under viscoelastic assessment results in reduced need for plasma and diminished overall transfusion requirements in severe trauma. J Trauma Acute Care Surg. 2022;doi: 10.1097/ta.0000000000003624 https://pubmed.ncbi.nlm.nih.gov/35358159/.
  • Barrett WJ, Kaucher KA, Orpet RE, et al. Tranexamic acid in trauma: A joint position statement and resource document of NAEMSP, ACEP, and ACS-COT. J Trauma Acute Care Surg. 2025;99(3):357-363. doi: 10.1097/ta.0000000000004727 https://pubmed.ncbi.nlm.nih.gov/40842057/.
  • Bouzat P, Charbit J, Abback PS, et al. Efficacy and safety of early administration of 4-factor prothrombin complex concentrate in patients with trauma at risk of massive transfusion: The PROCOAG randomized clinical trial. JAMA. 2023;329(16):1367-1375. doi: 10.1001/jama.2023.4080 https://pubmed.ncbi.nlm.nih.gov/36942533/.
  • Brito AMP, Kenny JE, Mitra B, et al. Thrombotic and thromboembolic events were not associated with tranexamic acid in three large randomized controlled trials. J Trauma Acute Care Surg. 2026;doi: 10.1097/ta.0000000000005010 https://pubmed.ncbi.nlm.nih.gov/42023936/.
  • Cobler-Lichter MD, Arcieri TR, Brochu BM, et al. Cryo on call: Pathogen-reduced cryoprecipitated fibrinogen complex is associated with improved fibrinogen supplementation in hemorrhaging trauma patients. J Trauma Acute Care Surg. 2026;100(3):446-452. doi: 10.1097/ta.0000000000004846 https://pubmed.ncbi.nlm.nih.gov/41417676/.
  • CRASH-3 trial collaborators. Effects of tranexamic acid on death, disability, vascular occlusive events and other morbidities in patients with acute traumatic brain injury (CRASH-3): a randomised, placebo-controlled trial. Lancet. 2019;394(10210):1713-1723. doi: 10.1016/s0140-6736(19)32233-0 https://pubmed.ncbi.nlm.nih.gov/31623894/.
  • Dhingra P, Yeung M, Lang E. Tranexamic acid in emergency medicine. An overview of reviews. Intern Emerg Med. 2023;18(1):211-218. doi: 10.1007/s11739-022-03155-x https://pubmed.ncbi.nlm.nih.gov/36562900/.
  • Dumas RP, Succar BE, Vella MA, et al. The use of tranexamic acid in the management of injured patients at risk of hemorrhage: a systematic review and meta-analysis and an Eastern Association for the Surgery of Trauma Practice Management Guideline. J Trauma Acute Care Surg. 2025;doi: 10.1097/ta.0000000000004773 https://pubmed.ncbi.nlm.nih.gov/40956301/.
  • Eisenkraft A, Wagnert-Avraham L, Azmon R, et al. Autoinjector-based delivery of tranexamic acid provides pharmacokinetic efficacy in a porcine model of uncontrolled hemorrhage. Injury. 2026;57(1):112721. doi: 10.1016/j.injury.2025.112721 https://pubmed.ncbi.nlm.nih.gov/40915868/.
  • El-Menyar A, Sathian B, Asim M, et al. Efficacy of prehospital administration of tranexamic acid in trauma patients: A meta-analysis of the randomized controlled trials. Am J Emerg Med. 2018;36(6):1079-1087. doi: 10.1016/j.ajem.2018.03.033 https://pubmed.ncbi.nlm.nih.gov/29573898/.
  • Fabes J, Brunskill SJ, Curry N, et al. Pro-coagulant haemostatic factors for the prevention and treatment of bleeding in people without haemophilia. Cochrane Database Syst Rev. 2018;12:Cd010649. doi: 10.1002/14651858.CD010649.pub2 https://pubmed.ncbi.nlm.nih.gov/30582172/.
  • Fouche PF, Stein C, Nichols M, et al. Tranexamic acid for traumatic injury in the emergency setting: A systematic review and bias-adjusted meta-analysis of randomized controlled trials. Ann Emerg Med. 2024;83(5):435-445. doi: 10.1016/j.annemergmed.2023.10.004 https://pubmed.ncbi.nlm.nih.gov/37999653/.
  • Gruen RL, Mitra B, Bernard SA, et al. Prehospital tranexamic acid for severe trauma. N Engl J Med. 2023;doi: 10.1056/NEJMoa2215457 https://pubmed.ncbi.nlm.nih.gov/37314244/.
  • Gunn F, Stevenson R, Almuwallad A, et al. A comparative analysis of tranexamic acid dosing strategies in traumatic major hemorrhage. J Trauma Acute Care Surg. 2024;96(2):216-224. doi: 10.1097/ta.0000000000004177 https://pubmed.ncbi.nlm.nih.gov/37872678/.
  • Guyette FX, Brown JB, Zenati MS, et al. Tranexamic acid during prehospital transport in patients at risk for hemorrhage after injury: A double-blind, placebo-controlled, randomized clinical trial. JAMA Surg. 2021;156(1):11-20. doi: 10.1001/jamasurg.2020.4350 https://pubmed.ncbi.nlm.nih.gov/33016996/.
  • Hannadjas I, James A, Davenport R, et al. Prothrombin complex concentrate (PCC) for treatment of trauma-induced coagulopathy: systematic review and meta-analyses. Crit Care. 2023;27(1):422. doi: 10.1186/s13054-023-04688-z https://pubmed.ncbi.nlm.nih.gov/37919775/.
  • Innerhofer N, Treichl B, Rugg C, et al. First-line administration of fibrinogen concentrate in the bleeding trauma patient: Searching for effective dosages and optimal post-treatment levels limiting massive transfusion—Further results of the RETIC study. J Clin Med. 2021;10(17) doi: 10.3390/jcm10173930 https://pubmed.ncbi.nlm.nih.gov/34501379/.
  • Itagaki Y, Hayakawa M, Maekawa K, et al. Early administration of fibrinogen concentrate is associated with improved survival among severe trauma patients: a single-centre propensity score-matched analysis. World J Emerg Surg. 2020;15:7. doi: 10.1186/s13017-020-0291-9 https://pubmed.ncbi.nlm.nih.gov/31956337/.
  • Itagaki Y, Hayakawa M, Takahashi Y, et al. Emergency administration of fibrinogen concentrate for haemorrhage: systematic review and meta-analysis. World J Emerg Surg. 2023;18(1):27. doi: 10.1186/s13017-023-00497-5 https://pubmed.ncbi.nlm.nih.gov/36998084/.
  • Karkouti K, Gareis M, Li C, et al. Twenty years of the four-factor prothrombin complex concentrate Octaplex/Balfaxar: A narrative review. Transfus Apher Sci. 2025;64(3):104115. doi: 10.1016/j.transci.2025.104115 https://pubmed.ncbi.nlm.nih.gov/40188746/.
  • Khurshid MH, Al Ma’ani M, Hejazi O, et al. Fibrinogen in resuscitation of older adult trauma patients: Are they too old to receive new adjuncts? J Surg Res. 2025;315:426-434. doi: 10.1016/j.jss.2025.09.045 https://pubmed.ncbi.nlm.nih.gov/41076778/.
  • Mazzei M, Donohue JK, Schreiber M, et al. Prehospital tranexamic acid is associated with a survival benefit without an increase in complications: results of two harmonized randomized clinical trials. J Trauma Acute Care Surg. 2024;doi: 10.1097/ta.0000000000004315 https://pubmed.ncbi.nlm.nih.gov/38523128/.
  • Meizoso JP, Dudaryk R, Mulder MB, et al. Increased risk of fibrinolysis shutdown among severely injured trauma patients receiving tranexamic acid. J Trauma Acute Care Surg. 2018;84(3):426-432. doi: 10.1097/ta.0000000000001792 https://pubmed.ncbi.nlm.nih.gov/29298240/.
  • Moore KK, Barton CA, Levins ES, et al. Reversal of warfarin and direct-acting oral anticoagulants in traumatic intracranial hemorrhage: Four factor prothrombin complex concentrates for all? Trauma. 2022;24(2):124-130. doi: 10.1177/1460408620970504 https://journals.sagepub.com/doi/10.1177/1460408620970504.
  • Morrison JJ, Dubose JJ, Rasmussen TE, et al. Military application of tranexamic acid in trauma emergency resuscitation (MATTERs) study. Arch Surg. 2012;147(2):113-9. doi: 10.1001/archsurg.2011.287 https://pubmed.ncbi.nlm.nih.gov/22006852/.
  • Neeki MM, Dong F, Toy J, et al. Safety and efficacy of hospital utilization of tranexamic acid in civilian adult trauma resuscitation. West J Emerg Med. 2020;21(2):217-225. doi: 10.5811/westjem.2019.10.43055 https://pubmed.ncbi.nlm.nih.gov/32191179/.
  • Nestor MA, Boling B. Reversing direct oral anticoagulants in acute intracranial hemorrhage. Crit Care Nurse. 2019;39(3):e1-e8. doi: 10.4037/ccn2019160 https://pubmed.ncbi.nlm.nih.gov/31154337/.
  • Newman ZC, McKinley WI, Nordgren RK, et al. Prehospital tranexamic acid and first 24-hour blood product transfusion in patients with isolated traumatic brain injury. J Am Coll Surg. 2025;241(1):7-15. doi: 10.1097/xcs.0000000000001401 https://pubmed.ncbi.nlm.nih.gov/40183448/.
  • Nishida T, Kinoshita T, Yamakawa K. Tranexamic acid and trauma-induced coagulopathy. J Intensive Care. 2017;5:5. doi: 10.1186/s40560-016-0201-0 https://pubmed.ncbi.nlm.nih.gov/28729903/.
  • Osawa I, Goto T, Roberts I. Tranexamic acid for trauma: optimal timing of administration based on the CRASH-2 and CRASH-3 trials. Br J Surg. 2025;112(4) doi: 10.1093/bjs/znaf079 https://pubmed.ncbi.nlm.nih.gov/40277024/.
  • Ozawa S, Nelson T. Clinical application of prothrombin complex concentrate in blood management in patients. Crit Care Nurse. 2017;37(2):49-56. doi: 10.4037/ccn2017333 https://pubmed.ncbi.nlm.nih.gov/28365649/.
  • Richards J, Fedeles BT, Chow JH, et al. Raising the bar on fibrinogen: a retrospective assessment of critical hypofibrinogenemia in severely injured trauma patients. Trauma Surg Acute Care Open. 2023;8(1):e000937. doi: 10.1136/tsaco-2022-000937 https://pubmed.ncbi.nlm.nih.gov/36726403/.
  • Roberts I, Shakur H, Coats T, et al. The CRASH-2 trial: a randomised controlled trial and economic evaluation of the effects of tranexamic acid on death, vascular occlusive events and transfusion requirement in bleeding trauma patients. Health Technol Assess. 2013;17(10):1-79. doi: 10.3310/hta17100 https://pubmed.ncbi.nlm.nih.gov/23477634/.
  • Rowell SE, Meier EN, McKnight B, et al. Effect of out-of-hospital tranexamic acid vs placebo on 6-month functional neurologic outcomes in patients with moderate or severe traumatic brain injury. JAMA. 2020;324(10):961-974. doi: 10.1001/jama.2020.8958 https://pubmed.ncbi.nlm.nih.gov/32897344/.
  • Thomas HM, Kahf H, Bush B, et al. Use of tranexamic acid in trauma surgical specialties: a narrative review. World J Emerg Surg. 2025;20(1):76. doi: 10.1186/s13017-025-00649-9 https://pubmed.ncbi.nlm.nih.gov/41074177/.
  • Thompson AA, Misra S, Ayasa L, et al. The critical role of tranexamic acid for bleeding patients. Vox Sang. 2025;doi: 10.1111/vox.70156 https://pubmed.ncbi.nlm.nih.gov/41253374/.
  • Walsh K, O’Keeffe F, Brent L, et al. Tranexamic acid for major trauma patients in Ireland. World J Emerg Med. 2022;13(1):11-17. doi: 10.5847/wjem.j.1920-8642.2022.003 https://pubmed.ncbi.nlm.nih.gov/35003409/.
  • Wang K, Santiago R. Tranexamic acid - A narrative review for the emergency medicine clinician. Am J Emerg Med. 2022;56:33-44. doi: 10.1016/j.ajem.2022.03.027 https://pubmed.ncbi.nlm.nih.gov/35364476/.
  • Zampieri FG, Young PJ, Bernard SA, et al. Impact of different preferred functional outcomes on the results of the pre-hospital antifibrinolytics for traumatic coagulopathy and hemorrhage (PATCH-trauma) trial. J Crit Care. 2026;91:155255. doi: 10.1016/j.jcrc.2025.155255 https://pubmed.ncbi.nlm.nih.gov/40945305/.
  • Zeeshan M, Hamidi M, Feinstein AJ, et al. Four-factor prothrombin complex concentrate is associated with improved survival in trauma-related hemorrhage: A nationwide propensity-matched analysis. J Trauma Acute Care Surg. 2019;87(2):274-281. doi: 10.1097/ta.0000000000002262 https://pubmed.ncbi.nlm.nih.gov/30889141/.

Topic: General bleeding, blood, transfusion concerns

  • Daniel Y, Dufour-Gaume F, Vergnaud A, et al. Adjuvant therapies for management of hemorrhagic shock: a narrative review. Crit Care. 2025;29(1):138. doi: 10.1186/s13054-025-05368-w https://pubmed.ncbi.nlm.nih.gov/40158128/.
  • Fiorellino J, Elahie AL, Warkentin TE. Acute haemolysis, DIC and renal failure after transfusion of uncross-matched blood during trauma resuscitation: illustrative case and literature review. Transfus Med. 2018;28(4):319-325. doi: 10.1111/tme.12513 https://pubmed.ncbi.nlm.nih.gov/29460456/.