Effects of prophylactic tranexamic acid on bleeding during transbronchial lung biopsy: a double-blind, randomized controlled trial.

BACKGROUND: This randomized controlled trial evaluated the efficacy of tranexamic acid in preventing bleeding in patients undergoing transbronchial lung biopsy. MATERIALS AND METHODS: This study was a double-blind, parallel-group, randomized controlled trial. Adult patients referred for flexible bronchoscopy with a planned transbronchial lung biopsy during 2024 were included in the current study. Participants in the intervention group received 10 mg/kg of intravenous tranexamic acid in normal saline, administered 20 minutes prior to the procedure. Those in the placebo group received an equal volume of normal saline. We assessed the need for bleeding control interventions, such as epinephrine or ice saline use, the incidence of tachycardia or hypotension, uncontrolled bleeding, and procedure length. We also measured the hemoglobin levels before and after the procedure. RESULTS: In total, 60 patients - 32 (53.3%) in the tranexamic acid group and 28 (46.7%) in the control group - were enrolled in the study. The percentage of females (53.6% vs. 28.1%) and the mean age of participants (66.5 vs. 42.9 years) were significantly higher in the control group compared to the tranexamic acid group (P < 0.05). After adjusting for age and gender, epinephrine use (18.8% vs. 92.9%) and the procedure length (median of 8 vs. 13 minutes) were lower in the tranexamic acid group compared to the control group (P < 0.05). Additionally, tranexamic acid had a statistically significant effect on post-operative hemoglobin levels (F = 14.08, P < 0.001, partial η2 = 0.207). CONCLUSIONS: Tranexamic acid can be effective in preventing bleeding in individuals undergoing transbronchial lung biopsy and in enhancing procedural speed.