The CRASH-2 trial demonstrated a significant reduction in all-cause mortality in trauma patients with significant haemorrhage when tranexamic acid was administered within what time window of injury?

• A Within 6 hours of injury
• B Within 1 hour of injury
• C Within 24 hours of injury
• D Within 3 hours of injury ✓

Explanation

The CRASH-2 trial (2010, 20,211 patients) showed that tranexamic acid (TXA) — an antifibrinolytic that inhibits plasmin — significantly reduced all-cause mortality and death due to bleeding when given within 3 hours of injury. Administration after 3 hours was not beneficial and possibly harmful. The CRASH-3 trial subsequently demonstrated benefit in traumatic brain injury. The current ATLS protocol recommends TXA within 3 hours of injury in adults with significant haemorrhage. The dose is 1 g IV over 10 minutes followed by 1 g IV over 8 hours.

Reference: Bailey & Love's Short Practice of Surgery, 27th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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