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World J Clin Cases. Aug 26, 2026; 14(24): 122847
Published online Aug 26, 2026. doi: 10.12998/wjcc.122847
Published online Aug 26, 2026. doi: 10.12998/wjcc.122847
Effectiveness and safety of antifibrinolytic agents in the management of pulmonary haemorrhage: A systematic review with narrative synthesis
Yasmin Kabir, MSc Acute Medicine, University of South Wales in association with Learna Ltd, University of South Wales, Cardiff CF37 1DL, United Kingdom
Jonathan Soldera, MSc Acute Medicine and Gastroenterology, University of South Wales in association with Learna Ltd, University of South Wales, Cardiff CF37 1DL, United Kingdom
Jonathan Soldera, Department of Gastroenterology, Logan Hospital, Brisbane 4131, Queens
Author contributions: Soldera J and Kabir Y participated in the concept and design research, drafted the manuscript and contributed to data acquisition, analysis and interpretation; Soldera J contributed to study supervision; all authors contributed to critical revision of the manuscript for important intellectual content.
AI contribution statement: AI tools were used in a limited capacity to assist with language refinement and summarization during the process of adapting a Master of Science thesis into manuscript form. No section of the manuscript was generated solely by AI without substantial human input, critical review, and revision by the authors. AI tools were not involved in study design, data collection, statistical analysis, or interpretation of results. All scientific content, conclusions, and final wording were determined by the authors. No figures, images, or graphical elements were generated using AI.
Conflict-of-interest statement: All authors declare that they have no conflict of interest to disclose.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2020 Checklist, and the manuscript was prepared and revised according to the PRISMA 2020 Statement.
Corresponding author: Jonathan Soldera, Tutor, MSc Acute Medicine and Gastroenterology, University of South Wales in association with Learna Ltd, University of South Wales, Llantwit Road, Pontypridd, Cardiff CF37 1DL, United Kingdom. jonathansoldera@gmail.com
Received: April 30, 2026
Revised: July 5, 2026
Accepted: July 20, 2026
Published online: August 26, 2026
Processing time: 112 Days and 11.8 Hours
Revised: July 5, 2026
Accepted: July 20, 2026
Published online: August 26, 2026
Processing time: 112 Days and 11.8 Hours
Core Tip
Core Tip: This systematic review with narrative synthesis shows that the apparent effect of tranexamic acid (TXA) on haemoptysis outcomes depends heavily on clinical context: Nebulised TXA improves bleeding control in stable, non-massive haemoptysis, whereas higher mortality reported with TXA in intensive care cohorts most likely reflects confounding by indication rather than drug harm. Route, severity, and population must therefore be considered together when interpreting TXA evidence, rather than treating haemoptysis as a single condition or TXA exposure as uniform across settings.