Case report demonstrates control of pulmonary hemorrhage in pediatric patients using nebulized tranexamic acid with transfusion therapy.
Pulmonary hemorrhage in pediatric patients represents a rare yet serious complication, particularly during extracorporeal membrane oxygenation (ECMO), requiring continuous systemic anticoagulation. We describe the successful use of nebulized tranexamic acid (TXA), administered in conjunction with blood products, to control pulmonary hemorrhage in a 20-month-old child supported on venovenous ECMO, without interruption of continuous intravenous bivalirudin. This case provides preliminary evidence that nebulized TXA, alongside conventional transfusion therapy, may serve as a feasible adjunct for managing pulmonary hemorrhage in the setting of ongoing systemic anticoagulation and mechanical circulatory support in pediatric patients.
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Gore et al. (2026) studied this question.
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