Bilateral pulmonary embolism while receiving tranexamic acid: a case report

Thromboembolic Events in Total Hip Arthroplasty:: A Report of 3 Cases in 2 Patients

CASE

We present 3 separate cases of thromboembolic events in 2 patients undergoing total hip arthroplasty (THA). These events occurred following acetabular component implantation, caused severe cardiac and pulmonary adverse events intraoperatively, and highlight the need to better understand risk factors of adverse coagulopathic outcomes during THA.

CONCLUSION

Various factors regarding thromboembolic risk require consideration before THA, including coagulopathies and predisposing risk factors of thrombi that could become embolic if dislodged during surgery. Identifying steps involving the greatest risk of thromboembolic adverse events, preventative measures, and contingency plans to deal with intraoperative complications during THA are critical.

Tranexamic Acid and Plasminogen/Plasmin Glaring Paradox in COVID-19

Coronavirus disease 2019 (COVID-19) is caused by a severe acute respiratory syndrome, coronavirus type 2 (SARS-CoV-2), leading to acute tissue injury and an overstated immune response. In COVID-19, there are noteworthy changes in the fibrinolytic system with the development of coagulopathy. Therefore, modulation of the fibrinolytic system may affect the course of COVID-19. Tranexamic acid (TXA) is an anti-fibrinolytic drug that reduces the conversion of plasminogen to plasmin, which is necessary for SARS-CoV-2 infectivity. In addition, TXA has anti-inflammatory, anti-platelet, and anti-thrombotic effects, which may attenuate the COVID-19 severity. Thus, in this narrative review, we try to find the beneficial and harmful effects of TXA in COVID-19.