UK’s NICE Proposes Wider Use of Tranexamic Acid

The United Kingdom’s National Institute for Health and Care Excellence (NICE) published draft guidance last month on the use of tranexamic acid (TXA) among surgical patients.  

The update revises recommendations from 2015 (sections 1.1.5 and 1.1.6), which advised offering TXA to adults expected to lose at least 500 mL of blood during surgery and to children expected to lose more than 10% of their blood volume.

For adults, NICE proposes administering TXA during surgery in an operating theater if there is a risk of bleeding and the procedure breaches the skin or mucous membranes. Outside an operating theater, NICE proposes administering TXA if the patient is expected to lose more than 500 mL of blood.

For pediatric patients aged 1 to 15 years, NICE proposes that clinicians consider TXA during surgery in an operating theater under the same bleeding risk criteria and, outside an operating theater, if the patient is expected to lose more than 10% of their blood volume.

Information on guideline development, including the guideline scope and evidence reviews, is available on the NICE web page. NICE expects to publish the final guidance in February.