A Randomized Controlled Trial of Inhaled Tranexamic Acid for the Treatment of Pulmonary Hemorrhage in Cancer Patients

Eligibility Criteria

• 1. Age \> 18 years old
• 2. Have a diagnosed hematological malignancy
• 3. Are actively receiving mechanical ventilation
• 4. Have evidence of pulmonary hemorrhage as defined by either
• 1. Persistently bloody secretions upon endotracheal tube suctioning, or
• 2. Evidence of diffuse alveolar hemorrhage by bronchoscopic examination
• 5. Signed informed consent by patient or if the subject lacks decision-making capacity, the subject's legally authorized representative
• 2.3.2 Exclusion Criteria
• 1. Presence of a Do Not Resuscitate (DNR), no escalation of care or comfort care order at the time of screening
• 2. Expected survival \< 48 hours
• 3. Evidence of nasal or oral spillage likely to be the cause of bloody secretions
• 4. Patients requiring 100% FIO2
• 5. Known hypersensitivity to tranexamic acid
• 6. Treatment with inhaled tranexamic acid prior to screening
• 7. Acquired defective color vision
• 8. Subarachnoid hemorrhage
• 9. Deep Venous or arterial thrombus diagnosed within the previous 3 months
• 10. Seizure disorder on active anti-epileptic therapies
• 11. Hypersensitivity to tranexamic acid or any of the ingredients
• 12. Pregnant women will not be eligible and have a negative pregnancy test prior to entering study
• 13. Patient receiving concurrent anti-fibrinolytic therapy
• 14. Confirmed active COVID-19 infection