Antifibrinolytic therapy to reduce haemoptysis from any cause

Prutsky, Gabriela; Domecq, Juan Pablo; Accinelli Tanaka, Roberto Alfonso; Salazar, Carlos A.

dc.contributor.author	Prutsky, Gabriela
dc.contributor.author	Domecq, Juan Pablo
dc.contributor.author	Salazar, Carlos A.
dc.contributor.author	Accinelli Tanaka, Roberto Alfonso
dc.date.accessioned	2019-02-22T14:56:09Z
dc.date.available	2019-02-22T14:56:09Z
dc.date.issued	2016
dc.identifier.uri	https://hdl.handle.net/20.500.12866/5846
dc.description.abstract	Background: Haemoptysis is a common pathology around the world, occurring with more frequency in low-income countries. It has different etiologies, many of which have infectious characteristics. Antifibrinolytic agents are commonly used to manage bleeding from different sources, but their usefulness in pulmonology is unclear. Objectives: To evaluate the effectiveness and safety of antifibrinolytic agents in reducing the volume and duration of haemoptysis in adult and paediatric patients. Search methods: We searched the Cochrane Central Register of Controlled Trials (CENTRAL) and the Database of Abstracts of Reviews of Effects (DARE) in The Cochrane Library, EMBASE and LILACS for publications that describe randomized controlled trials (RCTs) of antifibrinolytic therapy in patients presenting with haemoptysis. We also performed an independent search in MEDLINE for relevant trials not yet included in CENTRAL or DARE. Searches are up to date to the 19th September 2016. We conducted electronic and manual searches of relevant national and international journals. We reviewed the reference lists of included studies to locate relevant randomized controlled trials (RCTs). An additional search was carried out to find unpublished RCTs. Selection criteria: We included RCTs designed to evaluate the effectiveness and safety of antifibrinolytic agents in reducing haemoptysis in adult and paediatric patients of both genders presenting with haemoptysis of any etiology and severity. The intervention of interest was the administration of antifibrinolytic agents compared with placebo or no treatment. Data collection and analysis: All reviewers independently assessed methodological quality and extracted data tables pre-designed for this review. Main results: The electronic literature search identified 1 original study that met the eligibility criteria. One unpublished study was also identified through manual searches. Therefore two randomized controlled trials met the inclusion criteria: Tscheikuna 2002 (via electronic searches) and Ruiz 1994 (via manual searches). Tscheikuna 2002, a double-blind RCT performed in Thailand, evaluated the effectiveness of tranexamic acid (TXA, an antifibrinolytic agent) administered orally in 46 hospital in-and outpatients with haemoptysis of various etiologies. Ruiz 1994, a double-blind RCT performed in Peru, evaluated the effectiveness of intravenous TXA in 24 hospitalised patients presenting with haemoptysis secondary to tuberculosis. Pooled together, results demonstrated a significant reduction in bleeding time between patients receiving TXA and patients receiving placebo with a weighted mean difference (WMD) of -19.47 (95% CI -26.90 to -12.03 hours), but with high heterogeneity (I-2 = 52%). TXA did not affect remission of haemoptysis evaluated at seven days after the start of treatment. Adverse effects caused by the drug's mechanism of action were not reported. There was no significant difference in the incidence of mild side effects between active and placebo groups (OR 3.13, 95% CI 0.80 to 12.24). Authors' conclusions: There is insufficient evidence to judge whether antifibrinolytics should be used to treat haemoptysis from any cause, though limited evidence suggests they may reduce the duration of bleeding.	en_US
dc.language.iso	eng
dc.publisher	Wiley
dc.relation.ispartofseries	Cochrane Database of Systematic Reviews
dc.rights	info:eu-repo/semantics/restrictedAccess
dc.rights.uri	https://creativecommons.org/licenses/by-nc-nd/4.0/deed.es
dc.subject	Peru	en_US
dc.subject	Adult	en_US
dc.subject	Humans	en_US
dc.subject	Thailand	en_US
dc.subject	etiology	en_US
dc.subject	Administration	en_US
dc.subject	Antifibrinolytic Agents [administration & dosage	en_US
dc.subject	Hemoptysis [drug therapy	en_US
dc.subject	Injections	en_US
dc.subject	Intravenous	en_US
dc.subject	mortality]	en_US
dc.subject	Oral	en_US
dc.subject	RandomizedControlledTrials as Topic	en_US
dc.subject	therapeutic use]	en_US
dc.subject	Tranexamic Acid [administration& dosage	en_US
dc.title	Antifibrinolytic therapy to reduce haemoptysis from any cause	en_US
dc.type	info:eu-repo/semantics/review
dc.identifier.doi	https://doi.org/10.1002/14651858.CD008711.pub3
dc.subject.ocde	https://purl.org/pe-repo/ocde/ford#3.01.05
dc.relation.issn	1469-493X