Coagulopathy and Bleeding · Neurotrauma · TBI General · Traumatic Brain Injury

CRASH 3 Debate Continues – TXA in TBI: systematic review and meta-analysis trumps a large RCT? A Sobering Editorial by Maas et al.

Following the recent publication of a systematic review and meta-analysis by Al Lawati et al. on TXA in traumatic brain injury (showing no discernible benefit from TXA, yet suggesting no harm), the debate surrounding the findings of the CRASH-3 trial has been treated to another revival. In this editorial in Intensive Care Medicine Dr Andrew Maas and colleagues review the CRASH-3 results in light of the findings in the Al Lawati study, as well as in the broader context of what should constitute the most reliable evidence base, the large RCT or systematic reviews with appropriate meta-analyses. The article is well worth a read, especially if you (like me) remain somewhat uncertain about how to apply the ever-debatable CRASH-3 findings clinically.

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