Tranexamic acid use in the non-surgical neonatal population: a scoping review

Tranexamic acid (TXA) is recommended for use in paediatric major haemorrhage situations and paediatric surgery where major blood loss is anticipated. There are no recommendations regarding the use of TXA for major bleeding for neonates in a non-surgical context. This review evaluates existing literature relating to TXA use in neonates outside the surgical context. The limited available evidence indicates TXA can be a useful adjunct in management of neonatal non-surgical haemorrhage.

Jennifer Peterson^1,2
Neonatal Sub-Speciality Trainee
jennifer.peterson@hotmail.co.uk

Kate Pritchard³
Transport Advanced Neonatal Nurse Practitioner

Susan Kamupira²
Consultant Neonatologist

Ruth Gottstein²
Consultant Neonatologist

Ian Dady³
Consultant Neonatologist

¹Faculty of Biology, Medicine and Health, University of Manchester
²Neonatal Intensive Care Unit, St Mary’s Hospital, Manchester
³Connect North West Neonatal Transport Team, St Mary’s Hospital, Manchester

Peterson J., Pritchard K., Kamupira S., Gottstein R., Dady I. Tranexamic acid use in the non-surgical neonatal population: a scoping review. Infant 2024; 20(2): 49-54.

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Keywords

neonates; tranexamic acid; haemorrhage; bleeding; resuscitation

Key points

This literature review looks at TXA use for major haemorrhage in neonates in the non-surgical context.
TXA may be a useful adjunct for major haemorrhage in neonates with medical pathology.
There is risk of dose-dependent adverse events with current TXA dosing regimens.

Also published in Infant:

VOLUME 17/ISSUE 6, NOVEMBER 2021

Congenital myofibroma: an unusual neonatal presentation

The diagnosis of a vascular cutaneous appearing lesion in a neonate can be challenging. We report a case of a solitary congenital myofibroma presenting at birth as a major bleeding lesion. Further to the major haemorrhage and the ensuing hypoxia/ischaemia, the baby suffered multi-organ failure. This eventually led to redirection of care and neonatal death in about two weeks. On histopathological examination, the lesion showed a pattern identified as haemangio-pericytoma. This is a rare tumour involving blood vessels and soft tissues. In our literature search there is no other case report of a myofibromatous lesion presenting in this way. The importance of having an emergency haemorrhage protocol was highlighted with this incident.