The Effect of the Use of Tranexamic Acid (Cyclokapron) Prior to Flexible Bronchoscopy in Reduction Intra Procedural Bleeding in Sample of Iraqi Patients

Abstract

Background: Intraprocedural bleeding is a critical factor in procedural safety and operative success. Tranexamic acid (Cyclokapron), an antifibrinolytic agent, is widely used to reduce bleeding by inhibiting plasmin-mediated fibrinolysis. Objectives: To evaluate the efficacy of tranexamic acid in reducing intra-procedure bleeding compared with a non-treated control group. Materials and Methods: interventional study was conducted on 60 patients all underwent fibro-optic bronchoscopy with endo-bronchial biopsy from segmental lesions by 2.2 cm usual forceps for 4 passes  for diagnostic reasons under Local anesthesia ,group A: 30 patients do the procedure with the usual preparation ,group B : 30 patients as group A plus oral cyclocapron   before the procedure ,we take the demographic data (age and sex), recording Intra-procedure bleeding and monitoring the patients for any drug side effect, . For categorical comparisons, we used chi-square testing, and group differences were evaluated using non-parametric Wilcoxon testing. Statistical significance was determined at P ≤ 0.05. Results: The (p value) for age distribution was (P = 0.000), so there is significant difference between the two groups, while the distribution of sex was comparable (P = 0.500). Group A show10%   Intra-procedural bleeding and group B show 6.7% bleeding, with no statistically significant difference (P = 0.640). Similar results obtained from non-parametric tests (P = 0.655). The intra procedural bleeding was low in both groups. Conclusion: This study demonstrates that there is little rule for the preprocedural use of Tranexamic Acid (Cyclokapron) prior to flexible bronchoscopy in reduction intra procedural bleeding further studies are required for trying other techniques for this purpose even though the risk for this complication was not so significant regarding to the numbers but still important because it occur in anatomically risky area.