Tranexamic Acid Dosing for Gauze Soaks in Pediatric Patients

Introduction to Tranexamic Acid

Pediatric dosing of medications, including tranexamic acid, generally requires weight-based adjustments compared to adult dosing, as recommended by the American Society of Anesthesiologists 1

The principles of pediatric medication dosing can be applied to topical tranexamic acid application, with a recommended concentration of 500 mg in 5 mL (100 mg/mL) for gauze soaks, according to the American Academy of Pediatrics 2

Topical thrombin products, fibrin sealants, and oxidized cellulose or collagen hemostatic agents can be considered as alternative hemostatic approaches if tranexamic acid is unavailable or ineffective, with potential adverse effects including nausea, vomiting, or diarrhea 1
Systemic absorption from topical application is minimal, but potential adverse effects include hypotension, with rapid IV administration being less likely with topical use, as noted by the American College of Surgeons 2