Triple-Bolus vs Continuous TXA in CABG – Does Dosing Strategy Matter?

Exciting to see ongoing innovation in perioperative bleeding management and antifibrinolytic strategies. Australia offers outstanding opportunities to collaborate in cardiac surgery, haemostasis, and viscoelastic testing research.

A recent prospective study compared two tranexamic acid (TXA) strategies in adult patients undergoing isolated CABG:

 • Triple-dose IV bolus

 • IV bolus followed by continuous infusion

The triple-bolus regimen resulted in significantly lower postoperative bleeding at 6 hours with numerically lower bleeding at 1 and 24 hours. Transfusion requirements, ICU/hospital length of stay, and complication rates were similar between groups — and no seizures or thromboembolic events were observed. The authors conclude that triple-dose bolus TXA is a safe and effective alternative to continuous infusion in isolated CABG.

https://link.springer.com/article/10.1186/s13019-026-03877-5

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