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Tranexamic acid at cesarean delivery: drug-error deaths.
Moran, Neil F; Bishop, David G; Fawcus, Susan; Morris, Edward; Shakur-Still, Haleema; Devall, Adam J; Gallos, Ioannis D; Widmer, Mariana; Oladapo, Olufemi T; Coomarasamy, Arri; Hofmeyr, G Justus.
Afiliación
  • Moran NF; KwaZulu-Natal Department of Health, Durban, South Africa.
  • Bishop DG; Department of Obstetrics and Gynaecology, University of KwaZulu-Natal, Durban, South Africa.
  • Fawcus S; KwaZulu-Natal Department of Health, Durban, South Africa.
  • Morris E; Department of Anaesthesia, University of KwaZulu-Natal, Durban, South Africa.
  • Shakur-Still H; Department of Obstetrics and Gynaecology, University of Cape Town, Cape Town, South Africa.
  • Devall AJ; Department of Obstetrics and Gynaecology, Norfolk and Norwich University Hospital, Norwich, UK.
  • Gallos ID; London School of Hygiene & Tropical Medicine, London, UK.
  • Widmer M; World Health Organization Collaborating Centre for Global Women's Health, Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, UK.
  • Oladapo OT; UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction, Department of Sexual and Reproductive Health and Research, World Health Organization, Geneva, Switzerland.
  • Coomarasamy A; UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction, Department of Sexual and Reproductive Health and Research, World Health Organization, Geneva, Switzerland.
  • Hofmeyr GJ; UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction, Department of Sexual and Reproductive Health and Research, World Health Organization, Geneva, Switzerland.
BJOG ; 130(1): 114-117, 2023 01.
Article en En | MEDLINE | ID: mdl-36300729
The use of tranexamic acid for postpartum hemorrhage has entered obstetrical practice globally with the evidence-based expectation of saving lives. This improvement in the care of women with postpartum hemorrhage has come at a price. For the anesthetist, having tranexamic acid ampoules close at hand would seem an obvious strategy to facilitate its use during cesarean delivery, an important setting for severe hemorrhage. Tragically, we have identified a number of recent instances of inadvertent intrathecal administration of tranexamic acid instead of local anesthetic for spinal anesthesia. Reported cases of this catastrophic error seem to be increasing. The profound neurotoxicity of tranexamic acid causes rapid-onset convulsions, with mortality of 50%. How can these tragic errors be averted? Drug safety alerts have been issued by the US Food and Drug Administration and the World Health Organization, but that is not enough. We recommend extensive dissemination of information to raise awareness of this potential hazard, and local hospital protocols to ensure that tranexamic acid is stored separately from anesthetic drugs, preferably outside the operating room and with an auxiliary warning label. Implementation of safety strategies on a very large scale will be needed to ensure that the life-saving potential of tranexamic acid is not eclipsed by drug-error mortality.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Ácido Tranexámico / Hemorragia Posparto / Antifibrinolíticos Tipo de estudio: Guideline Límite: Female / Humans / Pregnancy Idioma: En Revista: BJOG Asunto de la revista: GINECOLOGIA / OBSTETRICIA Año: 2023 Tipo del documento: Article País de afiliación: Sudáfrica Pais de publicación: Reino Unido
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Ácido Tranexámico / Hemorragia Posparto / Antifibrinolíticos Tipo de estudio: Guideline Límite: Female / Humans / Pregnancy Idioma: En Revista: BJOG Asunto de la revista: GINECOLOGIA / OBSTETRICIA Año: 2023 Tipo del documento: Article País de afiliación: Sudáfrica Pais de publicación: Reino Unido