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Nebulized tranexamic acid for hemoptysis in critically and non-critically ill patients: A retrospective analysis Cover

Nebulized tranexamic acid for hemoptysis in critically and non-critically ill patients: A retrospective analysis

Open Access
|Jul 2025

Figures & Tables

Fig. 1.

Flowchart of patient eligibility screening
Flowchart of patient eligibility screening

Outcomes of all patients

OutcomesAll patients (N = 488)TXA (N = 96)No TXA (N = 392)p-value
ICU admission[N=224] 50%[N=72] 75%[N=151] 38.5%<0.01
Average ICU LOS10.5 (16.5)16.9 (17.6)7.3(14.9)<0.01
Mechanical ventilation155 (31.8%)64 (66.7%)91 (23.2%)<0.01
Bronchoscopy245 (50.2%)76 (79.2%)169 (43.1%)<0.01
IR29 (5.9%)8 (8.3%)21 (5.4%)0.27
Average Hospital LOS12.8 (17.1)24.4 (27.8)10 (11.6)<0.01
Expired/Hospice194 (39.8%)56 (59%)138 (35.2%)<0.01

Diagnosis
  Alveolar bleeding82 (16.8%)29 (30.2%)53 (13.5%)<0.01
  Infection161 (33%)26 (27.1%)135 (34.4%)0.17
  Pulmonary edema33 (6.8%)3 (3.1%)30 (7.6%)0.11
  Malignancy73 (15%)11 (11.5%)62 (15.8%)0.28
  Coagulopathy15 (3.1%)4 (4.2%)11 (2.8%)0.51
  Tracheal/bronchial bleeding91 (18.7%)16 (16.7%)75 (19.1%)0.58
  Vascular abnormality21 (4.3%)3 (3.1%)18 (4.6%)0.78
  Undetermined12 (2.5%)4 (4.2%)8 (2.1%)0.26

Demographic information of all patients

Demographic informationAll patients (N = 488)TXA (N = 96)No TXA (N = 392)p-value
Gender:
  Female177 (36.3%)41 (42.7%)136 (34.7%)0.14
  Male311 (63.7%)55 (57.3%)256 (65.3%)
Mean Age (SD)56.8 (16.7)58.0 (15.5)56.6 (17.0)0.44
Smokers110 (22.5%)14 (14.6%)96 (24.5%)0.04
AC/AP use313 (64.1%)75 (78.1%)238 (60.7%)<0.01
INR >= 1.5108 (22.1%)23 (24%)85 (21.7%)0.63
Median Platelet count (q1-q3)196 (84–277)197 (84–282)192.5 (78–258.5)0.36

Underlying condition
  Liver disease42 (8.6%)6 (6.3%)36 (9.2%)0.19
  Bronchiectasis45 (9.2%)7 (7.3%)38 (9.7%)
  Lung cancer/metastasis58 (11.9%)9 (9.4%)49 (12.5%)
  Head/Neck cancer16 (3.3%)7 (7.3%)9 (2.3%)
  Hematological cancer30 (6.2%)7 (7.3%)23 (5.9%)
  Other cancer31 (6.3%)8 (8.3%)23 (5.9%)
  None of the above266 (54.5%)52 (54.2%)214 (54.6%)

Demographic information of all ICU patients

Demographic informationALL ICU (N = 223)ICU + TXA (N = 72)ICU + No TXA (N = 151)p-value
Gender:
  Female84 (37.7%)31 (43.1%)53 (35.1%)0.25
  Male139 (62.3%)41 (56.9%)98 (64.9%)
Average Age58.4 (16.3)58.1 (16.1)58.6 (16.4)0.85
Smokers46 (20.6%)12 (16.7%)34 (22.5%)0.31
AC/AP use169 (75.8%)59 (81.9%)110 (72.9%)0.14
INR >= 1.555 (24.7%)17 (23.6%)38 (25.2%)0.80
Median Platelet count (q1-q3)178.5 (84–262)165.5 (78–246)181 (85–268)0.64

Underlying condition
  Liver disease26 (11.7%)5 (6.9%)21 (13.9%)0.64
  Bronchiectasis8 (3.6%)3 (4.2%)5 (3.3%)
  Lung cancer/metastasis22 (9.9%)5 (6.9%)17 (11.3%)
  Head/Neck cancer10 (4.5%)4 (5.6%)6 (4%)
  Hematological cancer11 (4.9%)3 (4.2%)8 (5.3%)
  Other cancer18 (8.1%)6 (8.3%)12 (8%)
  None of the above128 (57.4%)46 (63.9%)82 (54.3%)

Propensity score analysis for death

VariableOdds RatioConfidence Intervalsp-value
TXA Use:
  Yes2.511.56–4.02<0.01
  NoReference

Outcomes of ICU patients

OutcomesALL ICU (N = 223)ICU + TXA (N = 72)ICU + No TXA (N = 151)p-value
Median APACHE II scores17.6 (8.5)18.7 (9.1)17.1 (8.1)0.17
MV147 (65.9%)59 (81.9%)88 (58.3%)<0.01
Bronchoscopy155 (69.5%)61 (84.7%)94 (62.3%)<0.01
IR17 (7.6%)6 (8.3%)11 (7.3%)0.78
Average ICU LOS10.3 (16.4)16.6 (17.5)7.3 (15)<0.01
Average Hospital LOS16.5 (18.3)23.7 (19.9)13.1 (16.5)<0.01
Expired/Hospice113 (50.9%)44 (62%)69 (45.7%)0.02

Diagnosis
  Alveolar bleeding60 (26.9%)25 (34.7%)35 (23.2%)0.07
  Infection68 (30.5%)20 (27.8%)48 (31.8%)0.54
  Pulmonary edema12 (5.4%)1 (1.4%)11 (7.3%)0.11
  Malignancy25 (11.2%)6 (8.3%)19 (12.6%)0.50
  Coagulopathy8 (3.6%)1 (1.4%)7 (4.6%)0.44
  Tracheal/bronchial bleeding33 (14.8%)14 (19.4%)19 (12.6%)0.18
  Vascular abnormality10 (4.5%)2 (2.8%)8 (5.3%)0.51
  Undetermined7 (3.1%)3 (4.2%)4 (2.6%)0.68

TXA sources

CodeSource
81284-0611-10PROVEPHARM INC GWSA
67457-0197-10MYLAN INSTITUTIONAL LLC
39822-1000-01XGEN PHARM DJB INC
55150-0188-10EUGIA US LLC
83634-0401-10AVENACY INC GWSA
72485-0510-10ARMAS PHARMACEUTICALS INC
00013-1114-21PFIZER USPG
60505-6169-01APOTEX CORPORATION
67850-0041-10AVET PHARMACEUTICALS INC
61990-0611-02PROVEPHARM INC GWSA
00517-0960-10AMERICAN REGENT INC
47781-0601-91ALMAJECT INC
72611-0760-10ALMAJECT INC
70860-0400-10ATHENEX PHARMACEUTICAL DIVISION
70860-0407-10ATHENEX PHARMACEUTICAL DIVISION
DOI: https://doi.org/10.2478/jccm-2025-0031 | Journal eISSN: 2393-1817 | Journal ISSN: 2393-1809
Language: English
Page range: 233 - 239
Submitted on: Jan 5, 2025
Accepted on: Jul 3, 2025
Published on: Jul 31, 2025
Published by: University of Medicine, Pharmacy, Science and Technology of Targu Mures
In partnership with: Paradigm Publishing Services
Publication frequency: 4 issues per year

© 2025 Nancy Bethuel, Chris Naum, Cynthia Brown, published by University of Medicine, Pharmacy, Science and Technology of Targu Mures
This work is licensed under the Creative Commons Attribution 4.0 License.