Lung India. 2026 Jan 1;43(1):45-51. doi: 10.4103/lungindia.lungindia_264_25. Epub 2026 Jan 1.
ABSTRACT
INTRODUCTION: Intravenous (IV) tranexamic acid (TXA), an antifibrinolytic agent, is routinely used in the treatment of non-massive haemoptysis. Topical TXA has shown haemostatic efficacy in surgical settings and epistaxis. Limited case reports have documented successful management of pulmonary bleeding using nebulised TXA. This study was conducted to evaluate the efficacy of nebulised TXA compared to IV TXA in non-massive haemoptysis.
MATERIALS AND METHODS: This single-centre, randomised controlled trial included 46 adult patients with non-massive haemoptysis presenting to the Emergency Medicine department. They were randomised into two groups: IV TXA (n = 23), receiving 500 mg TXA IV 8th hourly, and nebulised TXA (n = 23), receiving 500 mg TXA via nebulisation 8th hourly. The volume of haemoptysis was recorded at presentation and at 8-hour intervals. Haemoglobin, liver, and renal function tests were recorded at admission, and haemoglobin was monitored daily. Data were analysed using appropriate statistical tests.
RESULTS: Among the 46 patients, 30 were male. The mean age in the IV TXA group was 51.83 ± 12.58 years and 49.91 ± 13.87 years in the nebulised TXA group (P = 0.63). There were two smokers in the IV group and eight in the nebulised group. Pulmonary tuberculosis was the most common cause in both groups. The mean bleeding volume at presentation was 58.26 ± 49.69 ml (IV) and 46.96 ± 38.30 ml (nebulised) (P = 0.39). Complete cessation of haemoptysis was achieved in 7.39 ± 5.02 h (IV) and 5.70 ± 4.80 h (nebulised) (P = 0.25). Repeat doses were required in 6 (IV) and 3 (nebulised) patients (P = 0.40). No adverse effects were observed.
CONCLUSION: Nebulised TXA is as effective as IV TXA in managing non-massive haemoptysis.
PMID:41474427 | DOI:10.4103/lungindia.lungindia_264_25
