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New research · Otolaryngology (ENT)
Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery · 1d
StudyOtolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery · 2026

Implementation of a Nebulized Tranexamic Acid Protocol for Pediatric Post-Tonsillectomy Hemorrhage: A Quality Improvement Initiative.

Kyle W Singerman, Andrea Nguyen, Blake Welker … Elie Khalifee
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Otolaryngology (ENT)Study

Nebulized tranexamic acid protocol linked to reduced need for surgery after tonsillectomy.

Implementation of a Nebulized Tranexamic Acid Protocol for Pediatric Post-Tonsillectomy Hemorrhage: A Quality Improvement Initiative.

Kyle W Singerman et al. · Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery · 2026
Purpose

We hypothesized that initiation of a standardized nebulized TXA protocol for posttonsillectomy hemorrhage (PTH) would reduce the need for surgical control of bleeding without increasing adverse clinical outcomes.

Methods

This quality improvement project included patients under 18 years of age who presented with PTH.

n = 501 patients
65.4%
Results
reduction
fewer patients needed surgery to stop bleeding after tonsil removal
n = 501 patients
More results

The proportion of patients requiring surgical control of bleeding decreased with each intervention (43.9% vs 29.8% vs 15.2%, P < .0001).

There were no changes in the length of stay, transfusion rates, readmissions, or TXA-related complications.

“
Conclusion

IMPLICATIONS FOR PRACTICE: Implementation of a nebulized TXA protocol may be a safe and effective management option for PTH.

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