©Author(s) (or their employer(s)) 2026. No commercial re-use. See Permissions. Published by Baishideng Publishing Group Inc.
World J Crit Care Med. Mar 9, 2026; 15(1): 115620
Published online Mar 9, 2026. doi: 10.5492/wjccm.v15.i1.115620
Published online Mar 9, 2026. doi: 10.5492/wjccm.v15.i1.115620
Myoclonus associated with tranexamic acid administration in a patient on veno-arterial extracorporeal membrane oxygenation support: A case report
Fotios Dimitriadis, Theodoros Pitsolis, Kyriaki Kolovou, Sissy Maragoulia, Evangelia Theodorou, Giorgos Konstantinou, Theodora Soulele, Ioannis Vlahodimitris, Michail Zervos, Paraskevi Salata, Dimitrios Elaiopoulos, Stavros Dimopoulos, Cardiac Surgery Intensive Care Unit, Onassis Cardiac Surgery Center, Athens 17674, Attikí, Greece
Stergios Gatzonis, 1st Department of Neurosurgery, National & Kapodistrian University of Athens, Athens 17674, Attikí, Greece
Author contributions: Dimopoulos S conceptualized the study; Dimitriadis F and Dimopoulos S designed the methodology; Dimitriadis F, Dimopoulos S, and Gatzonis S validated the data; Maragoulia S, Konstantinou G, Soulele T, Vlahodimitris I, Pitsolis T, Kolovou K, Elaiopoulos D and Theodorou E performed the formal analysis, investigation and provided resources; Salata P and Zervos M curated the data; Dimitriadis F wrote the original draft; Dimitriadis F and Dimopoulos S reviewed and edited the manuscript; Dimopoulos S supervised the study and administered the project; all authors have read and approved the final version of the manuscript.
Informed consent statement: Written informed consent has been obtained from the patient to publish this paper.
Conflict-of-interest statement: All authors declare no conflicts of interest related to this case report.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Corresponding author: Stavros Dimopoulos, MD, PhD, Cardiac Surgery Intensive Care Unit, Onassis Cardiac Surgery Center, 356 Syggrou Av, Athens 17674, Attikí, Greece.
Received: October 21, 2025
Revised: December 10, 2025
Accepted: January 21, 2026
Published online: March 9, 2026
Processing time: 130 Days and 14.1 Hours
Revised: December 10, 2025
Accepted: January 21, 2026
Published online: March 9, 2026
Processing time: 130 Days and 14.1 Hours
Core Tip
Core Tip: This article describes the first known case of tranexamic acid (TXA)-induced myoclonus in a patient receiving veno-arterial extracorporeal membrane oxygenation (ECMO) and continuous renal replacement therapy. TXA accumulation due to impaired renal clearance led to neurotoxicity, which resolved after drug discontinuation. The case underscores the need for individualized TXA dosing and vigilant neurological monitoring in ECMO patients with renal dysfunction, given the absence of standardized dosing protocols and the delicate hemostatic balance in this setting.