TXAIMS
TraneXamic Acid in Major Surgery
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Overview
Overview
TXAIMS is a national quality improvement project starting in August 2025 which aims to increase the use of Tranexamic Acid in major surgery in accordance with NICE Quality Statement 138. This states that ‘Adults who are having surgery and expected to have moderate blood loss (>500ml) receive tranexamic acid', with moderate blood loss defined as >500mls.(1)
With your help, we are hoping to increase tranexamic acid use in major surgery throughout the UK by adding a prompt for tranexamic acid to local WHO surgical sign-in checklists and implementing an education and guidance package. Full compliance with NICE quality statement 138 for tranexamic acid across the UK would prevent approximately 15,000 major surgical bleeds and avoid the transfusion of approximately 33,000 units of blood.(2) This project is run in collaboration with the Pan-London Perioperative Audit and Research Network and the NIHR Blood and Transplant Research Unit in Data-Driven Transfusion Practice.
Collaborator Involvement
Collaborator Involvement
The study will start on the 18th of August 2025 but we will continue to recruit new sites and collaborators until October. We are looking to recruit a resident lead +/- resident investigators and a consultant lead at each site. Each site team will receive a toolkit to make data collection and implementation as straightforward as possible. The project will consist of:
Phase 1 (18/08/2025 - 12/10/2025) – An eight-week audit of tranexamic use in major surgery
Phase 2 (13/10/2025 - 07/12/2025) – An eight-week implementation phase to update the local WHO surgical sign-in checklist and disseminate education and clinical guidance on tranexamic acid administration to local Anaesthetic and Surgical teams. Further eight-week audit of tranexamic acid use in major surgery
Phase 3 (08/12/2025 - 01/02/2026) – A further eight-week audit of tranexamic acid use in major surgery
For their contribution, study collaborators will receive:
1) Recognition as a collaborator on all future publications
2) A certificate for their portfolio as evidence towards quality improvement, research, and education domains
3) The opportunity to improve quality of care for thousands of patients
The following time commitments are expected:
Data collection – total of 6-24 hours spread across 24 weeks
Education and guidance dissemination – 2 or more short presentations per site, some additional time distributing emails and posters
WHO surgical checklist update – variable, predominantly email communication with local committees
If you would like to take part in TXAIMS as a collaborator please complete this short form to register and we will be in touch with next steps.
Further information is available in the Study Documents folder below. Please contact txaims.plan@gmail.com with any questions.
Investigators
Investigators
Chief Investigator
Dr Louis Murphy
Consultant Leads
Dr Samantha Warnakulasuriya
Dr Akshay Shah
Trainee Steering Group Members
Dr Mayur Murali
Dr Chris Oddy
Study Documents
Study Documents
Study Documents
Study Documents
Please see our site map for participating sites - you can email txaims.plan@gmail.com if you would like to register a new site or for information about the project at your site.
References
References
National Institute for Health and Care Excellence. Blood transfusion: NICE guideline [NG24], 2015.https://www.nice.org.uk/guidance/ng24 (accessed 19/06/2025)
Data taken from UK Royal Colleges Tranexamic Acid In Surgery Implementation Group - Tranexamic acid for safer surgery: the time is now. Grocott, Michael P.W. et al. British Journal of Anaesthesia, Volume 129, Issue 4, 459 – 461. doi:10.1016/j.bja.2022.06.024 pmid:36070986
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