ELi5 how Tranexamic acid (TXA) works in the body when used to treat hemorrhage/fluid resuscitation?
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Very short version: it results in more blood clots.
Slightly longer version: A clot forms when a protein called “fibrin” links together into a net that catches platelets and solidifies into a plug that stops blood from leaking out past it.
There’s an enzyme in the blood called plasmin. Plasmin breaks down fibrin, because you don’t want too much fibrin forming when you don’t need it- you do not want too many clots in your blood, and you want them to dissolve eventually.
Plasmin normally circulates around as a precursor form that isn’t active, called Plasminogen. It’s ready when you need it, but has to be activated first.
Tranexamic Acid stops plasminogen from turning into plasmin, which reduces the amount of plasmin available to break down fibrin, which means there’s more fibrin available to make clots. Clots stop bleeding, so you don’t have to put *in* as much blood/fluid because there’s not as much leaking out.
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