The effect of early tranexamic acid administration on hemoglobin levels after unstable pelvic fracture: An experimental study in rats

Aim: To investigate the effect of early systemic tranexamic acid (TRA) administration on hemoglobin (Hb) levels in rats with pelvic fracture. Method: In our study, 30 Wistar Albino rats were randomly divided into 3 groups in equal numbers and their hemoglobin levels were measured by taking blood samples from each. No trauma was applied to the first group and it was taken as the main control group of the study. Closed bilateral unstable pelvic fractures were created in all rats in groups 2 and 3. Fracture creation time is considered as minute 0. 10 minutes after the fracture was formed, TRA was given to the 1st group, TRA to the 2nd group and saline solution to the 3rd group systemically. Hemoglobin levels were measured by taking blood samples from all rats at 30th minute and 24th hour. The initial Hb values ​​obtained were normalized to 100 and the percentages of 30th minute and 24th hour values ​​were calculated. The initial, 30th minute and 24th hour values ​​of all groups were compared statistically with each other. The 30th minute and 24th hour values ​​were compared statistically between the groups. Results: No death was observed within 24 hours in all three groups. When the first Hb values ​​of each group are normalized to 100, the mean Hb percentages were calculated in the first group as 99.54 and 99.84 at 30 minutes and 24 hour, respectively; 92.95 and 87.73 in the second group; and 87.95 and 73.16 in the third group. When these values ​​obtained were compared statistically within the groups (initial, 30th minute, 24th hour Hb percentages), there was no significant difference between the initial, 30th minute and 24th hour values ​​in group 1. However, a statistically significant difference was found between the initial, 30th minute and 24th hour values ​​in group 2 and 3 (p<0.01). In the comparison between the groups, a statistically significant difference was found between group 1-2, group 1-3 and group 2-3 between both 30th minute and 24th hour values (p<0.01). Conclusion: In rats with bilateral unstable pelvic fractures due to blunt pelvis trauma, early administration of TRA after trauma significantly reduced the first 24-hour decrease in Hb value. Our study supports the early and prehospital use of TRA in traumas that are predicted to progress with acute bleeding, such as unstable pelvic fractures.