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Subcutaneous tranexamic acid for bleeding associated with a mycotic aortic aneurysm
  1. Mhairi Kilpatrick1,
  2. Susan Bateman1,
  3. Amy Baggott2 and
  4. Anna Sutherland1
  1. 1Strathcarron Hospice, Denny, UK
  2. 2Infectious Diseases Department, Forth Valley Royal Hospital, Larbert, UK
  1. Correspondence to Dr Mhairi Kilpatrick, Strathcarron Hospice, Denny, UK; mhairi.kilpatrick{at}


We describe the case of a 64-year-old woman with haemoptysis due to a mycotic thoracic aneurysm, with probable fistulation into the lung and oesophagus. Continuous subcutaneous tranexamic acid was used at the end of life to minimise bleeding associated with this, once the oral route was lost. A 1.5 g of tranexamic acid was administered, diluted with 23 mL water for injection in a 30 mL syringe, as a continuous subcutaneous infusion over 24 hours. Bleeding ceased rapidly following administration. There was no further bleeding in the last days before death and no site reaction noted. This case report adds to the growing evidence base for the use of subcutaneous tranexamic acid in a palliative care setting. However, further research is needed to support this practice both in terms of efficacy and safety, but also terms of compatibility and stability when administered by continuous subcutaneous infusion.

  • Drug administration
  • Hospice care
  • Pharmacology
  • Terminal care

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  • Contributors MK identified the case and drafted the manuscript, undertaking the literature review. SB, AB and AS both had input throughout the drafting of the final manuscript. AS had supervising author.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; internally peer reviewed.