Tranexamic acid in the management of post-procedural bleeding in bronchoscopy: A comprehensive review

Bronchoscopy, essential for respiratory diagnosis and treatment, carries a risk of post-procedural bleeding, especially in procedures like transbronchial lung biopsies (TBLB). This review evaluates tranexamic acid (TXA) for managing post-procedural bleeding in bronchoscopy. TXA is a synthetic lysine analog that inhibits plasminogen activation and promotes clot stability, therefore preventing and reducing bleeding. Evidence suggests that both topical and systemic administration can effectively reduce the incidence and severity of post-bronchoscopy bleeding. While generally well tolerated, considerations for TXA use include patient selection and awareness of potential risks, such as thromboembolic events. Further research is needed to establish optimal dosing regimens, administration routes, and long-term safety profiles to fully integrate TXA into bronchoscopy practice.